Effects of Patient-Centered Pharmaceutical Care on Medication Adherence in Patients with Major Depressive Disorder
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Abstract
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Objective: To determine medication adherence and severity of depression in patients with major depressive disorder between those receiving patient-centered pharmaceutical care and those receiving usual care. Methods: This study was a randomized controlled trial in outpatients with major depressive disorder at Somdet Chaopraya Institute of Psychiatry. Patient-centered pharmaceutical care involved patient interview to identify drug related needs, medication planning with patient and education on the disease and drugs. The assessment of medication adherence and severity of depressive symptoms were performed twice one month apart. Results: Two hundred and six participants were divided into the study and control groups with 103 patients in each, Participants were stratified by treatment history into 82 newly treated cases and 124 ongoing therapy cases. The pharmaceutical care group had a significantly higher mean of medication adherence compared to that of control group (22.54 ± 2.21 and 21.29 ± 2.97, respectively, P=0.001). The proportions of patients at various levels of medication adherence in the study group significantly differed from those in the control groups (P=0.009). Proportion of patients with high medication adherence in the study group increased from 20.2% to 44.7%, while that in the control group increased from 22.2% to 26.7%. Among patients with low medication adherence, the pharmaceutical care group showed significantly lower depression severity scores compared to the control group (13.32 ± 4.50, 15.75 ± 5.31, respectively, P=0.032). Conclusion: Patient-centered pharmaceutical care improved medication adherence in patients with major depressive disorder. Among patients with low medication adherence, this intervention was more effective in reducing depression severity compared to standard care.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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