Comparison of pharmacist-led outpatient depression management to current prescriber-led depression management

Considering the expected decrease in psychiatrists due to retirements and fewer individuals entering the field, it is important to examine the pharmacist's role in improving mental health outcomes. This study evaluated pharmacist treatment of depression in a behavioral health-integrated virtual (BHIV) clinic where patients were generally followed twice monthly compared with the standard of care, twice-yearly primary care management.

A descriptive report from January 1, 2020, to May 31, 2023, identified patients diagnosed with depression managed in the pharmacist-run BHIV clinic and the internal medicine (IM) clinics. Patients were excluded if they were established with a psychiatric specialist, diagnosed with a severe psychiatric disorder or postpartum depression, pregnant, or only prescribed trazodone at doses less than 100 mg. One hundred forty-two patients were included, with 71 in each group. The primary outcome was the final Patient Health Questionnaire-9 (PHQ-9) score.

The average initial PHQ-9 score was equal in both groups (13 ± 4.5; 13 ± 5.5; P = 0.8). The average final PHQ-9 score was similar between groups (7 ± 5.6; 6 ± 6.6; P = 0.7). The average time to remission and response in weeks was shorter in the BHIV group (9 ± 6.4; 27 ± 20.5; P ≤ 0.001; 7 ± 5.9; 29 ± 26.0; P ≤ 0.001).

Remission and response were identified more rapidly in the BHIV group than in the IM group. Clinical outcomes were comparable between cohorts at the final assessment. Overall, this shows that pharmacists can provide close follow-up and improve patients' quality of life by providing rapid symptom resolution.