The overall objective of the proposed initiative is to develop a replicable model for depression interventions in community pharmacies. We will teach the pharmacists counseling and referral skills specific to depression. The model will coordinate the efforts of both pharmacist and technician for efficiency. The intervention will be administered to persons aged 55 and older who frequent community-based pharmacies and will include a depression screening, education around signs and symptoms of depression, the importance of treatment, understanding barriers to care, medication adherence, and patient follow-up. The project has three specific objectives including training 3 months, implementation 6 months, and evaluation 3 months: Objective 1a To train the pharmacist to provide brief counseling andor education to patients who screen positive for depression, and to make referral to the clients primary care provider or to a mental health provider for full diagnostic work-up-- 1b To train the pharmacy technician to do the paperwork and documentation, get informed consent, and to hand the patient the self-administered screen. After the screen is complete, the technician will give it to the pharmacist for scoring and counseling if appropriate. The screen will be administered to patients aged 55 or older who request it. 1c To train pharmacists and technicians to educate pharmacy clients around mental health issues by distributing brochures on mental health. We will adapt consumer education materials developed by the Positive Aging Resource Center Sue Levkoff, PI. 2 To implement the intervention screening, counselingeducation, referral and patient follow-up at two matched community based pharmacies, one in Kansas City, MO and another in Boston, MA. 3 To evaluate the effects of the intervention on client outcomes number of clients screened, clients who screen positive, clients referred, clients who go to the referral, number of those returning to the pharmacy with prescriptions for antidepressants, number who contact the pharmacisttechnician with questions around medication management-- and number of follow up contacts, and client satisfaction with the service.
Brigham and Womens Hospital, Department of Psychi