A cross-sectional look at rural pharmacists' perceptions on implementing a depression screening service in their...

Rural areas are in desperate need of access to mental health care. Rural pharmacists can begin to fill these gaps by offering depression screening services. However, despite evidence suggesting improved patient outcomes and positive reception to pharmacist-led depression screening services, implementation has remained low. Research on barriers toward implementing depression screening services and preferred implementation strategies is necessary to increase the implementation of this service.

Investigate barriers, facilitators, and preferred implementation strategies to implementing a depression screening service in rural pharmacies.

An exploratory cross-sectional survey was conducted electronically amongst rural pharmacists in Alabama and Mississippi. The survey was developed and pretested with a stakeholder panel to identify rural pharmacist confidence, barriers or facilitators, stigma toward patients with mental health conditions, and preferred implementation strategies toward implementing a depression screening service. Likert-type questions from 1 (strongly disagree) to 5 (strongly agree), a rank-choice question, and open-ended questions were used. Quantitative and qualitative data were analyzed descriptively, with qualitative data also analyzed thematically.

A total of 84 rural pharmacists participated in the study. Confidence toward performing depression screenings and using a depression screening tool (the Patient Health Questionnaire-9) was low with a mean of 2.5 [SD = 1.1] and 2.0 [SD = 0.9] out of 5, respectively. The most strongly endorsed and highest ranked barrier was lack of time. Every implementation strategy was scored primarily as "helpful" or "very helpful." The most cited qualitative theme was financial concerns.

Pharmacists have low confidence in performing a depression screening service and several structural barriers such as time and financial concerns. Future research should perform cost benefit analyses of implemented depression screening services and assess whether training programs improve confidence toward offering these advanced care services.