Impact of a Depression-Specific Pharmaceutical Care Counseling and Smartphone App in Medication Adherence among Patients with Major Depressive Disorders: A pilot study

Pharmacy Practice

  • Kotchakorn Nianmongkon1Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.
  • Tanaporn Samphao1Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.
  • Panpachara Nuchchom2Department of Pharmacy, Suan Prung Psychiatric Hospital, Chiang Mai 50200, Thailand.
  • Jannapas Tharavichitkun3Department of Pharmaceutical Care, Center for Medical and Health Technology Assessment (CM-HTA), Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.
  • Rewadee Jenraumjit4Department of Pharmaceutical Care, Faculty of Pharmacy, Center for Medical and Health Technology Assessment (CM-HTA), Master of Science Program (Mental Health), Multidisciplinary School, Chiang Mai University, Chiang Mai 50200, Thailand.

Volume 22 Issue 3 Pages 1-8

DOI: 10.18549/PharmPract.2024.1.2969

Abstract

Introduction: Medication nonadherence has a number of clinical consequences, including an increased risk of relapse and recurrence. By offering individualized in-person pharmaceutical care counseling, pharmacists play a significant part in encouraging medication adherence. One of the most popular forms of communication in nowadays is the smartphone. As a result, one of the measures for enhancing patients’ outcomes should be a smartphone app specifically designed for depression. Objectives: To investigate whether depression-specific counseling and smartphone app could improve medication adherence in newly diagnosed MDD patients. Methods: A prospective, randomized, pilot study was conducted in newly diagnosed major depressive disorder patients. They were randomly assigned to either the intervention or usual care groups (1:1). The intervention included in-person pharmaceutical care counseling along with the introduction use of a depression-specific smartphone app, whereas the usual care group received traditional pharmaceutical care counseling and simple chatbot. The primary outcome, medication adherence was measured using the Medication Adherence Rating Scale (MARS) and the percentage of pills counted (PC) at the one-month follow-up. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms as a secondary outcome. Results: The study was completed by 36 participants (18 intervention and 18 usual care). The average age was 29.81 years, and 65.38% of the participants were female. The two groups had similar baseline characteristics, including baseline PHQ-9 scores. The intervention group had a mean MARS score of 7.0 (IQR=5) higher than the usual group, which had a mean score of 4.5 (IQR=7; p-value=0.04). The intervention group had a higher PC percentage of 81.75 (IQR=33.33) more than the usual care group, which had a mean percentage of 69.95 (IQR=78.57; p-value=0.10). The mean difference of PHQ-9 scores between two visits for the intervention and usual groups was -1.44 [-2.61 - -0.28]. (p-value=0.02). Discussion and Conclusions: This study discovered that new patients with major depression who received depression-specific pharmaceutical care counseling along with smartphone app improved their medication adherence. In addition, improvement in overall depression symptoms was discovered.

Keywords

  • medication adherence
  • pharmaceutical care
  • counseling smartphone
  • pharmacist
  • depression
  • mental health
Pharmacy Practice

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