• Atencion primaria · May 2016

    Randomized Controlled Trial

    [Impact of pharmaceutical intervention in preventing relapses in depression in Primary Care].

    • María Rubio-Valera, M Teresa Peñarrubia-María, Rita Fernández-Vergel, Andrea Cecilia Carvajal Tejadillo, Ana Fernández Sánchez, Ignacio Aznar-Lou, Marian March-Pujol, and Antoni Serrano-Blanco.
    • Unidad de investigación y desarrollo, Fundació Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España; Departamento de Prácticas Tuteladas, Facultad de Farmacia, Universidad de Barcelona, Barcelona, España; Grupo de Investigación Prisma, Red de Investigación Española en Actividades Preventivas y de Promoción de la Salud en Atención Primaria (RedIAPP), Barcelona, España.
    • Aten Primaria. 2016 May 1; 48 (5): 308-15.

    ObjectiveTo evaluate the long-term impact of a brief pharmacist intervention (PI) compared with usual care (UC) on prevention of depression relapse.Designrandomised controlled clinical trialSettingPrimary CareParticipantsOf the 179 depressed patients initiating antidepressants, the 113 whose clinical symptoms had remitted (main definition) at 6 months assessment were selected for this secondary study (PI=58; UC=55).InterventionPI was an interview to promote medication adherence when patients get antidepressants from pharmacy.Main MeasurementsBaseline, 3 months, and six-months follow-up assessments were made. The severity of depressive symptoms was evaluated with PHQ9. Patients presenting a remission of symptoms were selected. The patient medical records were reviewed to identify a relapse in the following 12 months by using 4 indicators.ResultsThere was a lower proportion of patients that relapsed in the PI group than in the UC group 18 months after initiation of treatment, but the difference was not statistically significant either in the intent-to-treat analysis (OR=0.734 [95%CI; 0.273-1.975]) or the per-protocol analysis (OR=0.615 [95%CI; 0.183 -2.060]). All the sensitivity analyses showed consistent results. The sample size and adherence to the protocol in the intervention group were low.ConclusionPI group showed a non-statistically significant tendency towards presenting fewer relapses. This could be related to the improvement in adherence among patients that received the intervention.Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

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