What clinical role could pharmacists play in mental health management?

A study recently published in the Journal of Mental Health enrolled pharmacies and consumers to participate in an intervention trial, to look into the potential effectiveness of interventions run in community pharmacies for mental health consumers.

Pharmacies were screened to ensure adequate staffing levels; appropriate private counselling areas; and staff completion of online training.

Consumers were eligible if they were over 18 years old, lived in the community and were prescribed medication for a common mental illness (primarily anxiety or depression).

The primary focus of the intervention was to identify, prevent and manage medication-related problems as well as “promote mental well-being”, explain the authors.

“Pharmacy staff worked with consumers and other healthcare team members to develop a tailored, goal-oriented support plan.”

Just over 400 consumers were involved in the study altogether – with 295 of these having completed the intervention.

There were no differences found between completers and non-completers for scores relating to beliefs around medication, including necessity, concerns, effectiveness, side effects or convenience.

Positively, consumers were significantly less concerned about adverse medication consequences after the intervention (p = 0.001).

In terms of medication satisfaction, a significant improvement was seen for medication effectiveness and global satisfaction after the intervention (p < 0.001).

Overall there was a reduction in the number of consumers with low adherence and a corresponding increase in those reporting medium adherence (p = 0.005).

“Significantly more positive attitudes were seen regarding medication use,” say the authors, who add that these results have also been seen in other studies (Rickles et al. 2005; Brook et al. 2003).

“This is a particularly important result, as it would be expected that a more positive attitude would be aligned with improved medication adherence.

“This study strengthens suggestions that pharmacist interventions have a positive impact on adherence to antidepressant medication.”

The next question is, do pharmacists have the time or inclination to conduct such interventions?

The authors suggest that a further large-scale study is warranted, which should include a sound assessment of the cost-effectiveness of the intervention.

“Trained community pharmacy staff can effectively provide a medication support service to mental health consumers with depression or anxiety,” they say.

“With the ongoing struggle towards improving mental healthcare and access to services, it would be remiss of the pharmacy profession and healthcare policy makers no to consider such positive outcomes.”