Efficiencies and outcomes of depression treatment by a psychiatric pharmacist in a primary care clinic compared with treatment within a behavioral health clinic

Abstract

ObjectiveThis study compared the efficiency and increased access to care by a psychiatric pharmacist (PP) incorporated into primary care versus behavioral health clinic (BHC) prescribers for depression treatment. SettingThe pharmacist’s practice was based in the primary care clinics of an urban Federally Qualified Community Health Center (FQCHC). Practice descriptionPP entered into a supervised collaborative practice agreement at the FQCHC. Primary care providers referred patients to PP for depression treatment. Practice innovationPPs have been utilized as psychiatric providers within psychiatric settings, but not in primary care. Integrating a PP within primary care can assist patients in obtaining more rapid, individualized mental health treatment. EvaluationInvestigators retrospectively screened the records of adults treated at a FQCHC with a primary diagnosis of depression referred for antidepressant management to (1) the PP over a 2 year period (study group [SG]), versus (2) the FQCHC’s BHC over the year preceding the PP’s arrival (control group [CG]). Both groups were compared using serial PHQ-9 data and wait time until initial evaluation. Pharmacist’s patients treated during a 2-month period also completed a satisfaction survey. ResultsThe SG and CG included 107 and 34 patients respectively. Average PHQ-9 scores decreased from 17.9 ± 6.51 at baseline to 14.7 ± 7.0 at follow-up #1 in the SG (P < 0.001), whereas there were minimal PHQ-9 data in CG. Time from treatment referral to initial medication evaluation averaged 31.3 days in the SG and 104.5 days in the CG (P < 0.001). The 39 SG patients demonstrated high satisfaction, with a mean of 26.8 out of 28 points. ConclusionPP incorporation into primary care produced positive outcomes and improved depression treatment access. Patients maintained reduced PHQ-9 scores and were seen in one-third the time versus those seen in the BHC. PP utilization in primary care is viable for treating depression.