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Mandlate F, Greene MC, Pereira LF, Sweetland AC, Kokonya D, Duarte CS, Cournos F, Oquendo MA, Wainberg ML, Sidat M, Sevene E, Mello MF. Lay HIV counselors' knowledge and attitudes toward depression: A mixed-methods cross-sectional study at primary healthcare centers in Mozambique. Front Public Health 2022; 10:919827. [PMID: 36249253 PMCID: PMC9554257 DOI: 10.3389/fpubh.2022.919827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 08/31/2022] [Indexed: 01/22/2023] Open
Abstract
Introduction Depression is the most common mental disorder among people living with HIV/AIDS and has a negative impact on HIV treatment outcomes. Training lay HIV counselors to identify and manage depression may contribute to improved patient access and adherence to treatment, and reduce stigma and discrimination among lay health workers toward both HIV and depression. The purpose of this study was to assess the current knowledge and attitudes of lay HIV counselors toward managing depression in primary care in Mozambique. Methods We conducted a mixed-methods cross-sectional study to assess depression-related knowledge and attitudes among lay HIV counselors in 13 primary healthcare facilities in Mozambique. We used the quantitative Depression Attitude Questionnaire (DAQ) scale, followed by open-ended questions to further explore three key DAQ domains: the nature of depression, treatment preferences, and professional attitudes or reactions. Results The sample included 107 participants (77.6% female, mean age: 32.3 years, sd = 7.4). Most (82.2%) had less than a high/technical school education. Findings suggested that some HIV counselors had knowledge of depression and described it as a cluster of psychological symptoms (e.g., deep sadness, anguish, apathy, isolation, and low self-esteem) sometimes leading to suicidal thoughts, or as a consequence of life stressors such as loss of a loved one, abuse, unemployment or physical illness, including being diagnosed with HIV infection. HIV counselors identified talking to trusted people about their problems, including family and/or counseling with a psychotherapist, as the best way for patients to deal with depression. While acknowledging challenges, counselors found working with patients with depression to be rewarding. Conclusion Lay health counselors identified HIV and psychosocial issues as key risk factors for depression. They believed that the treatment approach should focus on social support and psychotherapy.
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Affiliation(s)
- Flavio Mandlate
- Department of Mental Health, Ministry of Health, Maputo, Mozambique
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
| | - M. Claire Greene
- Program on Forced Migration and Health, Heilbrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Luis F. Pereira
- New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Annika C. Sweetland
- New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Donald Kokonya
- School of Medicine, Masinde Muliro University of Science and Technology, Kakamega, Kenya
| | - Cristiane S. Duarte
- New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Francine Cournos
- New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Maria A. Oquendo
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Milton L. Wainberg
- New York State Psychiatric Institute, Columbia University, New York, NY, United States
| | - Mohsin Sidat
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Esperança Sevene
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Marcelo F. Mello
- Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil
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Shami R, Alam MF, ElHajj MS. The role of community pharmacists in depression management: a survey of attitudes, practices and perceived barriers. Int J Clin Pharm 2021; 44:214-226. [PMID: 34661831 DOI: 10.1007/s11096-021-01337-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 10/04/2021] [Indexed: 11/25/2022]
Abstract
Background Community pharmacists play a significant role in depression care. Depression is a health priority in national health strategies around the world, including in Qatar. Objective To describe current practices, attitudes and perceived barriers of community pharmacists towards depression care, and to investigate factors associated with these practices. Setting Community pharmacies in Qatar. Method A cross-sectional online survey using an adapted survey instrument. Scores were measured on a five-point Likert scale. Descriptive univariate and bivariate analyses of study outcomes, followed by multivariate regression examining the association between pharmacists' practices and their attitudes, socio-demographic and professional characteristics. Main outcome measure Pharmacists' scores on self-reported attitudes towards depression and depression care practices and the number of perceived barriers for depression care. Result: 358 pharmacists (response rate 39%) completed the questionnaire. Pharmacists' attitudes to depression were moderately positive (mean score = 3.41, SD = 0.26) but involvement in depression care was very low (mean score = 2.64, SD = 0.94). Three major barriers were lack of access to patients' medical records (83.21%), lack of patients' insight on depression and the importance of treatment (81.85%), and lack of knowledge and training on mental health (79.63%). Female pharmacists and those graduated more than 10 years prior were significantly less involved in depression care compared to their counterparts (practice scores (95% CI) -4.36 (-7.46 to -1.26) and -7.51 (-15.10 to -1.35), respectively), while those who had access to private counselling area were more involved (practice score 3.39 (0.20 to 6.59). Pharmacists' depression practice score was positively associated with attitudes (p = 0.001). Conclusion Pharmacists' moderately positive attitudes were not reflected in their suboptimal depression-care practices. Action from policymakers is needed to improve pharmacists' practices and attitudes to depression.
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Affiliation(s)
- Rula Shami
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, PO Box 2713, Doha, Qatar
| | - Mohammed Fasihul Alam
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, PO Box 2713, Doha, Qatar.
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Muyambi K, Gillam M, Dennis S, Gray R, Martinez L, Jones M. Effect of depression awareness and management training on the attitudes of rural primary health care workers. Aust J Rural Health 2021; 29:449-454. [PMID: 34110058 DOI: 10.1111/ajr.12685] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/24/2020] [Accepted: 10/18/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To measure the effect of depression awareness and management training on the attitudes of rural primary health care workers. DESIGN A repeated measures design in which participants acted as their own controls. SETTING The training program occurred in 6 locations across rural South Australia. PARTICIPANTS The study enrolled primary care workers in general practitioner surgeries, Aboriginal Community Controlled Health Organisations, community health centres, public hospitals, regional health services and non-government organisations. INTERVENTION A six-session training workshop that was informed by the National Institute for Health and Care Excellence guidelines for the treatment and care of people with depression. MAIN OUTCOME MEASURE The 22-item Revised Depression Attitude Questionnaire comprised the main outcome measure. Participants were assessed 12 weeks before the training, again on the day of commencement of the training and after the training. RESULTS Seventy-two primary health workers completed the training program in depression awareness, building therapeutic relationships, working with ambivalence, and goal setting. Between the 2 pre-training assessments mean scores showed no significant difference. There were statistically significant improvements on the overall attitudes and the subscales therapeutic optimism and professional confidence between pre-training and post-training. CONCLUSION Training rural primary health care workers in depression may improve their attitudes to working with people living with depression.
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Affiliation(s)
- Kuda Muyambi
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Marianne Gillam
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Shaun Dennis
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,Flinders and Upper North Local Health Network, Whyalla, SA, Australia
| | - Richard Gray
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
| | - Lee Martinez
- University of South Australia Department of Rural Health, Adelaide, SA, Australia
| | - Martin Jones
- University of South Australia Department of Rural Health, Adelaide, SA, Australia.,School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia
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Liekens S, Smits T, Laekeman G, Foulon V. Factors determining social distance toward people with depression among community pharmacists. Eur Psychiatry 2020; 27:528-35. [DOI: 10.1016/j.eurpsy.2010.12.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Revised: 12/09/2010] [Accepted: 12/16/2010] [Indexed: 10/18/2022] Open
Abstract
AbstractObjectiveThe aim of the present study was to measure stigma among community pharmacists regarding patients with depression, using social distance as a proxy measure. Furthermore, factors influencing stigmatization were identified.MethodsA survey consisting of questions regarding social distance, cognitive attitude components, stereotypical beliefs and behavioural tendencies towards pharmaceutical care for patients with depression was carried out. The survey was completed by 149 community pharmacists with a response rate of 82%. Multiple linear regression analysis was applied to the results of the survey.ResultsMost pharmacists endorsed social distance towards patients with depression. The social distance further increased the more the situation described implied “social closeness”. Age, depression care attitude, the stereotypical belief “danger to others” and the level of involvement pharmacists showed towards patients with depression were found to predict social distance. The present model explains 32.3% of the variance in social distance.ConclusionThe results showed that community pharmacists have a stigmatizing attitude towards patients with depression. The determinants found to influence these stigmatizing attitudes might be addressed when trying to reduce stigmatization of patients with depression.
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Shoji M, Fujiwara A, Onda M. Creation and validation of a semi-quantitative instrument to assess the confidence of pharmacists in medication consultation for patients with depression: The pharmacists' confidence scale about medication consultation for depressive patients (PCMCD). Pharm Pract (Granada) 2020; 17:1628. [PMID: 31897261 PMCID: PMC6935550 DOI: 10.18549/pharmpract.2019.4.1628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 10/20/2019] [Indexed: 11/14/2022] Open
Abstract
Objectives To develop a semi-quantitative instrument to assess pharmacists' confidence in medication counseling for patients with depression, The Pharmacists' Confidence scale about Medication Consultation for Depressive patients (PCMCD), and investigated its validity. Methods Following discussions with practicing pharmacists, we developed a 12-item questionnaire to assess pharmacists' confidence in medication counseling for patients with depression. We launched web-based cross-sectional survey during November and December 2018 to 77 pharmacists employed at drug chain stores in Kansai area. Factor analysis was performed to evaluate the configuration concept validity. The least-squares method was used for factor extraction, and the resulting factors were subjected to direct oblimin rotation, with a factor loading cut-off of 0.4. To assess internal consistency, Cronbach's alpha values were calculated for each of the extracted factors (subscales). A multiple regression analysis was performed using simultaneous forced entry, with the scores obtained for each subscale as dependent variables and responder attributes as independent variables in order to investigate the factors associated with each subscale. Results During the factor analysis procedure, four questions were excluded by the cut-off rule. Eventually, a model with three subscales was identified, with a cumulative sum of squared loadings being 61.9%. The subscales were termed "relationship building," "comprehension of condition," and "information provision" based on the nature of the questions relevant for each of them. The Cronbach's alpha values for these subscales were 0.92, 0.73, and 0.72, respectively. The average inter-item correlation was 0.378. In addition, multiple regression analysis revealed that there were significant correlations between pharmacist career and both relationship building and information provision. Conclusions The PCMCD model demonstrated a satisfactory construct validity and internal consistency. This model will provide an excellent tool for assessing pharmacists' confidence in depression care.
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Affiliation(s)
- Masaki Shoji
- PhD. Assistant Professor. Department of Social and Administrative Pharmacy, Osaka University of Pharmaceutical Sciences. Osaka (Japan).
| | - Atsuko Fujiwara
- BPharm. General manager of Division of Planning and management of pharmacists training. Apis Pharmacy. Osaka (Japan).
| | - Mitsuko Onda
- PhD. Professor. Department of Social and Administrative Pharmacy, Osaka University of Pharmaceutical Sciences. Osaka (Japan).
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El-Den S, O'Reilly CL, Gardner DM, Murphy AL, Chen TF. Content validation of a questionnaire measuring basic perinatal depression knowledge. Women Health 2018; 59:615-630. [PMID: 30481138 DOI: 10.1080/03630242.2018.1539431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Perinatal depression (PND) screening is encouraged in healthcare settings. We aimed to develop and content validate a basic PND knowledge questionnaire for use among pharmacists and potentially other primary healthcare professionals (HCPs). A six-item questionnaire was developed. Twenty-five perinatal mental health experts were invited to participate in content validation by completing the questionnaire and assessing its content validity. A content validity index (CVI) score above 0.8 was indicative of content validity. Expert comments may inform items' deletion or revision. Between November 2016 and February 2017, ten experts participated. For five out of six items, the CVI score was 0.9 or 1.0. Two experts selected "I think none are correct" for one item regarding the onset of postpartum depression. Comments reflected the lack of consensus in the literature surrounding onset periods and prevalence rates and informed minor modifications to three of six questions and seven of 24 response options. The CVI for the questionnaire was 0.83.Content validation of a questionnaire measuring basic PND knowledge resulted in modifications. Comments about PND onset and prevalence indicated the need for consistency when defining and measuring these constructs. This questionnaire may be used among pharmacists and other HCPs.
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Affiliation(s)
- Sarira El-Den
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
| | - Claire L O'Reilly
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
| | - David M Gardner
- b Department of Psychiatry , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Andrea L Murphy
- c College of Pharmacy, Dalhousie University , Halifax , Nova Scotia , Canada
| | - Timothy F Chen
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
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Wei Y, McGrath P, Hayden J, Kutcher S. The quality of mental health literacy measurement tools evaluating the stigma of mental illness: a systematic review. Epidemiol Psychiatr Sci 2018; 27:433-462. [PMID: 28462747 PMCID: PMC6999021 DOI: 10.1017/s2045796017000178] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 03/26/2017] [Indexed: 01/08/2023] Open
Abstract
AIMS Stigma of mental illness is a significant barrier to receiving mental health care. However, measurement tools evaluating stigma of mental illness have not been systematically assessed for their quality. We conducted a systematic review to critically appraise the methodological quality of studies assessing psychometrics of stigma measurement tools and determined the level of evidence of overall quality of psychometric properties of included tools. METHODS We searched PubMed, PsycINFO, EMBASE, CINAHL, the Cochrane Library and ERIC databases for eligible studies. We conducted risk-of-bias analysis with the Consensus-based Standards for the Selection of Health Measurement Instruments checklist, rating studies as excellent, good, fair or poor. We further rated the level of evidence of the overall quality of psychometric properties, combining the study quality and quality of each psychometric property, as: strong, moderate, limited, conflicting or unknown. RESULTS We identified 117 studies evaluating psychometric properties of 101 tools. The quality of specific studies varied, with ratings of: excellent (n = 5); good (mostly on internal consistency (n = 67)); fair (mostly on structural validity, n = 89 and construct validity, n = 85); and poor (mostly on internal consistency, n = 36). The overall quality of psychometric properties also varied from: strong (mostly content validity, n = 3), moderate (mostly internal consistency, n = 55), limited (mostly structural validity, n = 55 and construct validity, n = 46), conflicting (mostly test-retest reliability, n = 9) and unknown (mostly internal consistency, n = 36). CONCLUSIONS We identified 12 tools demonstrating limited evidence or above for (+, ++, +++) all their properties, 69 tools reaching these levels of evidence for some of their properties, and 20 tools that did not meet the minimum level of evidence for all of their properties. We note that further research on stigma tool development is needed to ensure appropriate application.
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Affiliation(s)
- Y. Wei
- Faculty of Graduate Studies, Interdisciplinary PhD, Dalhousie University, Halifax, Nova Scotia, Canada
| | - P. McGrath
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - J. Hayden
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - S. Kutcher
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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El-Den S, O'Reilly CL, Chen TF. Development and Psychometric Evaluation of a Questionnaire to Measure Attitudes Toward Perinatal Depression and Acceptability of Screening: The PND Attitudes and Screening Acceptability Questionnaire (PASAQ). Eval Health Prof 2018; 42:498-522. [PMID: 30265131 DOI: 10.1177/0163278718801434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Prior to implementing perinatal depression (PND) screening, health-care professionals' acceptability of screening and their attitudes toward PND should be explored. We aimed to develop and psychometrically evaluate a questionnaire measuring PND attitudes and screening acceptability. A 31-item questionnaire was developed based on published questionnaires and a systematic review on PND screening acceptability. Principal components analysis with direct oblimin rotation was used to determine construct validity. Reliability of the resulting components was explored using Cronbach's α. Pharmacists (N = 153) were recruited from the Australian Association of Consultant Pharmacy. The scree plot and parallel analysis indicated a six-component solution. Due to cross-loadings (<.2 difference) and low loadings (<.445), it was necessary to delete 7 items. The six components explored PND screening acceptability, screening readiness, stigma, attitudes toward treatment efficacy, medication counseling responsibility, and the effect PND has on others. The six components explained 59.8% of the variance. Item loadings ranged from .445 to .880. Cronbach's α for each component ranged from .45 to .86. The construct validity and internal consistency reliability of the PND attitudes and screening acceptability questionnaire have been explored. Future measurements of these constructs using uniform, psychometrically sound scales may facilitate comparisons across studies.
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Affiliation(s)
- Sarira El-Den
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
| | - Claire L O'Reilly
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
| | - Timothy F Chen
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
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Fowler JL, McConachie B, Hattingh L, Wheeler AJ. Mentoring pharmacy staff to implement a medication support service: An evaluation of process and outcomes. CURRENTS IN PHARMACY TEACHING & LEARNING 2018; 10:886-894. [PMID: 30236425 DOI: 10.1016/j.cptl.2018.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 01/16/2018] [Accepted: 04/02/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION To investigate the effectiveness of mentoring of pharmacy staff as they implemented a medication support service for mental health consumers. In particular, to show the relevance and applicability of Kram's four phases of mentoring to short-term mentoring relationships, the type of mentoring functions provided, and the value of utilising a pharmacist-consumer mentoring pair. METHOD 163 pharmacy staff (mentees) each participated in a one-day workshop prior to implementing the service and being mentored over a period of six months. Data were collected from mentees via pre- and post-training questionnaires, and from mentors in the form of diaries, field notes, and a focus group. Quantitative and qualitative analyses were employed. RESULTS Kram's 4-phase model is relevant and applicable to short-term mentoring relationships. Mentoring functions increased after initiation, peaked during cultivation, and decreased during separation and redefinition. According to the mentors, both mentees and mentors benefitted from utilising a pair of mentors, each of whom had particular knowledge, experience, and perspectives to share. CONCLUSIONS This study extends mentoring research by showing that Kram's four phases could be intentionally integrated into the planning and implementation of mentoring relationships; moreover in short-term relationships. In addition, it has identified the particular mentoring functions that are sought and provided in different phases of relationships and that quantity of mentoring changes over the course of a relationship. Further, the study has found that mentees benefit from pairs of mentors (in this case a pharmacist and a consumer or carer) who provide different insights, knowledge and perspectives. Individuals and health-related organisations embarking on mentoring could use these findings as a guide to develop successful mentoring relationships, particularly when implementing a new service.
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Affiliation(s)
- Jane L Fowler
- School of Human Services and Social Work and Menzies Health Institute, Griffith University, Brisbane, Australia.
| | - Brad McConachie
- School of Human Services and Social Work, Griffith University, Brisbane, Australia
| | - Laetitia Hattingh
- School of Pharmacy and Menzies Health Institute, Griffith University, Brisbane, Australia.
| | - Amanda J Wheeler
- Menzies Health Institute, Griffith University, Brisbane, Australia; Faculty of Health Sciences, University of Auckland, New Zealand.
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Giannetti V, Caley CF, Kamal KM, Covvey JR, McKee J, Wells BG, Najarian DM, Dunn TJ, Vadagam P. Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs. Int J Clin Pharm 2018; 40:1096-1105. [PMID: 29862460 DOI: 10.1007/s11096-018-0619-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 03/15/2018] [Indexed: 11/24/2022]
Abstract
Background Half of Americans experience mental illness during their lifetime. Significant opportunity exists for community pharmacists to deliver services to these patients; however, personal and practice-related barriers may prevent full engagement. Objective To assess the demographics, practice characteristics, service provision, stigma, attitudes and beliefs of a national sample of community pharmacists towards individuals with mental illness. Setting National random sample of 3008 community pharmacists in the USA. Method 101-item cross-sectional mailed survey questionnaire on: (1) demographics, (2) knowledge and practice characteristics, (3) provision of clinical pharmacy services, and (4) comparative opinions. Main outcome measure Scaled measures of service provision (comfort, confidence, willingness and interest) and comparative opinions (stigma, attitudes and beliefs) of mental illness, four linear regression models to predict service provision. Results A total of 239 responses were received (response rate 7.95%). Across pharmacy services, ratings for willingness/interest were higher than those for comfort/confidence. Pharmacists who reported providing medication therapy management (MTM) services for patients reported higher comfort (18.36 vs. 17.46, p < 0.05), confidence (17.73 vs. 16.01, p < 0.05), willingness (20.0 vs. 18.62, p < 0.05) and interest (19.13 vs. 17.66, p < 0.05). Pharmacists with personal experience with mental illness also resulted in higher scores across all four domains of service provision, lower levels of stigma (18.28 vs. 20.76, p < 0.05) and more positive attitudes (52.24 vs. 50.53, p < 0.01). Regression analyses demonstrated increased frequency of MTM service delivery and more positive attitudes as significantly predictive across all four models for comfort, confidence, willingness and interest. Increased delivery of pharmacy services was significantly associated with both willingness and interest to provide mental illness-specific services. Conclusion Despite willingness/interest to provide services to patients with mental illness, decreased levels of comfort/confidence remain service-related barriers for community pharmacists.
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Affiliation(s)
- Vincent Giannetti
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, 600 Forbes Ave, Pittsburgh, PA, 15282, USA.
| | - Charles F Caley
- Department of Pharmacy Practice, Western New England University College of Pharmacy and Health Sciences, 1215 Wilbraham Road, Springfield, MA, 01119, USA
| | - Khalid M Kamal
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, 600 Forbes Ave, Pittsburgh, PA, 15282, USA
| | - Jordan R Covvey
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, 600 Forbes Ave, Pittsburgh, PA, 15282, USA
| | - Jerry McKee
- Community Care of North Carolina, 2300 Rexwoods Drive, Raleigh, NC, 27607, USA
| | - Barbara G Wells
- The University of Mississippi School of Pharmacy, University, MS, 38677, USA
| | - Dean M Najarian
- Janssen Scientific Affairs, 1771 West Street, Wrentham, MA, 02093, USA
| | - Tyler J Dunn
- The University of Mississippi School of Pharmacy, University, MS, 38677, USA
| | - Pratyusha Vadagam
- Envision Pharma Group, 205 East 42nd Street, New York, NY, 10017, USA
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Wheeler AJ, Mey A, Fowler JL, Mihala G, Kelly F. A web-based mental health promotion intervention for pharmacy staff to reduce stigmatising and discriminating attitudes. Health Promot J Austr 2018; 29:328-336. [PMID: 30511487 DOI: 10.1002/hpja.33] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 12/13/2017] [Indexed: 11/11/2022] Open
Abstract
ISSUE ADDRESSED Stigma and discrimination can have a significant impact on successful mental health recovery. This research evaluated the effectiveness of a web-based mental health promotion intervention on stigma and discrimination in community pharmacies via assessment of staff attitudes, confidence and skills. METHODS Guided by the intervention mapping framework, we used experiential learning techniques, including pre-recorded consumer/carer narratives, role-plays and panel discussions accessed by participants in an innovative, flexible, web-based, program of modules. A quasi-experimental pre-post design was used to evaluate the intervention effectiveness. Participants completed pre- (T1) and post-intervention (T2) questionnaires that contained both validated measures and questions developed or adapted specifically for this evaluation. RESULTS 566 pharmacy staff (357 pharmacists, 209 support staff) completed the intervention between September 2012 and May 2013; pharmacists completed eight online modules (4-hours total), support staff completed four (2-hours total). After participating, staff attitudes about mental health had changed in a positive direction; their confidence and skills when working with consumers and their carers had increased overall, although support staff remained less confident than pharmacists. CONCLUSION These results suggest that the involvement of consumers and carers in the intervention development and delivery was integral to reducing pharmacy staff stigma and enhancing confidence and communication skills.
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Affiliation(s)
- Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Amary Mey
- School of Pharmacy, Griffith University, Gold Coast, QLD, Australia
| | - Jane L Fowler
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Gabor Mihala
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Fiona Kelly
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,School of Pharmacy, Griffith University, Gold Coast, QLD, Australia
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Haddad M, Waqas A, Sukhera AB, Tarar AZ. The psychometric characteristics of the revised depression attitude questionnaire (R-DAQ) in Pakistani medical practitioners: a cross-sectional study of doctors in Lahore. BMC Res Notes 2017; 10:333. [PMID: 28750688 PMCID: PMC5530926 DOI: 10.1186/s13104-017-2652-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/21/2017] [Indexed: 11/10/2022] Open
Abstract
Background Depression is common mental health problem and leading contributor to the global burden of disease. The attitudes and beliefs of the public and of health professionals influence social acceptance and affect the esteem and help-seeking of people experiencing mental health problems. The attitudes of clinicians are particularly relevant to their role in accurately recognising and providing appropriate support and management of depression. This study examines the characteristics of the revised depression attitude questionnaire (R-DAQ) with doctors working in healthcare settings in Lahore, Pakistan. Methods A cross-sectional survey was conducted in 2015 using the revised depression attitude questionnaire (R-DAQ). A convenience sample of 700 medical practitioners based in six hospitals in Lahore was approached to participate in the survey. The R-DAQ structure was examined using Parallel Analysis from polychoric correlations. Unweighted least squares analysis (ULSA) was used for factor extraction. Model fit was estimated using goodness-of-fit indices and the root mean square of standardized residuals (RMSR), and internal consistency reliability for the overall scale and subscales was assessed using reliability estimates based on Mislevy and Bock (BILOG 3 Item analysis and test scoring with binary logistic models. Mooresville: Scientific Software, 55) and the McDonald’s Omega statistic. Findings using this approach were compared with principal axis factor analysis based on Pearson correlation matrix. Results 601 (86%) of the doctors approached consented to participate in the study. Exploratory factor analysis of R-DAQ scale responses demonstrated the same 3-factor structure as in the UK development study, though analyses indicated removal of 7 of the 22 items because of weak loading or poor model fit. The 3 factor solution accounted for 49.8% of the common variance. Scale reliability and internal consistency were adequate: total scale standardised alpha was 0.694; subscale reliability for professional confidence was 0.732, therapeutic optimism/pessimism was 0.638, and generalist perspective was 0.769. Conclusions The R-DAQ was developed with a predominantly UK-based sample of health professionals. This study indicates that this scale functions adequately and provides a valid measure of depression attitudes for medical practitioners in Pakistan, with the same factor structure as in the scale development sample. However, optimal scale function necessitated removal of several items, with a 15-item scale enabling the most parsimonious factor solution for this population.
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Affiliation(s)
- Mark Haddad
- Centre for Mental Health Research; School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK. .,East London NHS Foundation Trust, London, UK.
| | - Ahmed Waqas
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
| | | | - Asad Zaman Tarar
- CMH Lahore Medical College and Institute of Dentistry, Lahore, Pakistan
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Watkins A, McKee J, Hughes C, Pfeiffenberger T. Community pharmacists’ attitudes toward providing care and services to patients with severe and persistent mental illness. J Am Pharm Assoc (2003) 2017; 57:S217-S224.e2. [DOI: 10.1016/j.japh.2017.02.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/30/2017] [Accepted: 02/13/2017] [Indexed: 10/19/2022]
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14
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Murphy AL, Phelan H, Haslam S, Martin-Misener R, Kutcher SP, Gardner DM. Community pharmacists' experiences in mental illness and addictions care: a qualitative study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2016; 11:6. [PMID: 26821700 PMCID: PMC4730654 DOI: 10.1186/s13011-016-0050-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 01/18/2016] [Indexed: 11/10/2022]
Abstract
Background Community pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Although some existing research supports that community pharmacists’ interventions result in improved patient mental health outcomes, gaps in knowledge regarding the pharmacists’ experiences with service provision to this population remain. Improving knowledge regarding the pharmacists’ experiences with mental illness and addictions service provision can facilitate a better understanding of their perspectives and be used to inform the development and implementation of interventions delivered by community pharmacists for people with lived experience of mental illness and addictions in communities. Methods We conducted a qualitative study using a directed content analysis and the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework for theme development. The Theoretical Domains Framework facilitates understanding of behaviours of health care professionals and implementation challenges and opportunities for interventions in health care. Thematic analysis co-occurred throughout the process of the directed content analysis. We recruited community pharmacists, with experience dispensing psychotropics, at a minimum, through multiple mechanisms (e.g., professional associations) in a convenience sampling approach. Potential participants were offered the option of focus groups or interviews. Results Data were collected from one focus group and two interviews involving six pharmacists. Theoretical Domains Framework coding was primarily weighted in two domains: social/professional role and identity and environmental context and resources. We identified five main themes in the experiences of pharmacists in mental illness and addictions care: competing interests, demands, and time; relationships, rapport, and trust; stigma; collaboration and triage; and role expectations and clarity. Conclusions Pharmacists are not practicing to their full scope of practice in mental illness and addictions care for several reasons including limitations within the work environment and lack of structures and processes in place to be fully engaged as health care professionals. More research and policy work are needed to examine better integration of pharmacists as members of the mental health care team in communities. Electronic supplementary material The online version of this article (doi:10.1186/s13011-016-0050-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea L Murphy
- College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Heather Phelan
- College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Scott Haslam
- College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Ruth Martin-Misener
- School of Nursing, Dalhousie University, 5869 University Ave., PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Stan P Kutcher
- Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University/IWK Health Centre, 5850 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada.
| | - David M Gardner
- Department of Psychiatry, Dalhousie University, QEII HSC, AJLB 7517, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada.
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Scahill S, Fowler JL, Hattingh HL, Kelly F, Wheeler AJ. Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy. SAGE Open Med 2015; 3:2050312115603002. [PMID: 26770802 PMCID: PMC4679331 DOI: 10.1177/2050312115603002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 07/31/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Mental health-related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. METHODS This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. RESULTS Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. CONCLUSION The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole.
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Affiliation(s)
- Shane Scahill
- School of Management, Massey Business School, Massey University, Auckland, New Zealand
- School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - Jane L Fowler
- Griffith Health Institute, Griffith University, Brisbane, QLD, Australia
| | | | - Fiona Kelly
- School of Pharmacy, Griffith University, Gold Coast Campus, Brisbane, QLD, Australia
| | - Amanda J Wheeler
- Mental Health, Population & Social Health Research Program, Griffith Health Institute, Griffith University, Brisbane, QLD, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Wenger LM, Rosenthal M, Sharpe JP, Waite N. Confronting inequities: A scoping review of the literature on pharmacist practice and health-related disparities. Res Social Adm Pharm 2015; 12:175-217. [PMID: 26119111 DOI: 10.1016/j.sapharm.2015.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 05/22/2015] [Accepted: 05/23/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND An expanding body of literature is exploring the presence and impact of health and health care disparities among marginalized populations. This research challenges policy makers, health professionals, and scholars to examine how unjust and avoidable inequities are created at the societal, institutional, and individual level, and explore strategies for mitigating challenges. OBJECTIVES Recognizing the significance of this broader conversation, this scoping review provides an overview of pharmacy-specific research attentive to health-related disparities. METHODS Following Arksey and O'Malley's framework, a rigorous screening process yielded 93 peer-reviewed and 23 grey literature articles, each analyzed for core themes. RESULTS Lending critical insight to how pharmacy practice researchers are conceptualizing and measuring health inequities, this review highlights three paths of inquiry evident across this literature, including research focused on what pharmacists know about marginalized groups, how pharmacists perceive these groups, and how they provide services. Striving to drive research and practice forward, this review details research gaps and opportunities, including a need to expand the scope of research and integrate knowledge. CONCLUSIONS As pharmacists endeavor to provide equitable and impactful patient care, it is essential to understand challenges, and build strong evidence for meaningful action.
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Affiliation(s)
- Lisa M Wenger
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada.
| | - Meagen Rosenthal
- School of Pharmacy, The University of Mississippi, P.O. Box 1848, University, MS 38677, USA
| | - Jane Pearson Sharpe
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada
| | - Nancy Waite
- Ontario Pharmacy Research Collaboration (OPEN), School of Pharmacy, University of Waterloo, 10 Victoria St S, Kitchener, ON N2G1C5, Canada
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17
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Exploring the relationship between mental health stigma, knowledge and provision of pharmacy services for consumers with schizophrenia. Res Social Adm Pharm 2015; 11:e101-9. [DOI: 10.1016/j.sapharm.2013.04.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 04/04/2013] [Accepted: 04/04/2013] [Indexed: 11/16/2022]
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Haddad M, Menchetti M, McKeown E, Tylee A, Mann A. The development and psychometric properties of a measure of clinicians' attitudes to depression: the revised Depression Attitude Questionnaire (R-DAQ). BMC Psychiatry 2015; 15:7. [PMID: 25653089 PMCID: PMC4321322 DOI: 10.1186/s12888-014-0381-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 12/26/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is a common mental disorder associated with substantial disability. It is inadequately recognised and managed, and clinicians' attitudes to this condition and its treatment may play a part in this. Most research in this area has used the Depression Attitude Questionnaire (DAQ), but analyses have shown this measure to exhibit problems in psychometric properties and suitability for the health professionals and settings where depression recognition may occur. METHODS We revised the DAQ using a pooled review of findings from studies using this measure, together with a Delphi study which sought the opinions of a panel of relevant experts based in the UK, USA, Australia, and European countries (n = 24) using 3 rounds of questioning to consider attitude dimensions, content, and item wording. After item generation, revision and consensus (agreement >70%) using the Delphi panel, the revised DAQ (R-DAQ) was tested with 1193 health care providers to determine its psychometric properties. Finally the test-retest reliability of the R-DAQ was examined with 38 participants. RESULTS The 22-item R-DAQ scale showed good internal consistency: Cronbach's alpha coefficient was 0.84; and satisfactory test-retest reliability: intraclass correlation coefficient was 0.62 (95% C.I. 0.37 to 0.78). Exploratory factor analysis favoured a three-factor structure (professional confidence, therapeutic optimism/pessimism, and a generalist perspective), which accounted for 45.3% of the variance. CONCLUSIONS The R-DAQ provides a revised tool for examining clinicians' views and understanding of depression. It addresses important weaknesses in the original measure whilst retaining items and dimensions that appeared valid. This revised scale is likely to be useful in examining attitudes across the health professional workforce and beyond the confines of the UK, and may be valuable for the purpose of evaluating training that aims to address clinicians' attitudes to depression. It incorporates key dimensions of attitudes with a modest number of items making it applicable to use in busy clinical settings.
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Affiliation(s)
- Mark Haddad
- Centre for Mental Health Research, School of Health Sciences, City University London, Northampton Square, London, EC1V 0HB, UK.
| | - Marco Menchetti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
| | - Eamonn McKeown
- Centre for Health Services Research, City University London, London, UK.
| | - André Tylee
- Section of Primary Care Mental Health, Health Services and Population Research Department, King's College London, London, UK.
| | - Anthony Mann
- Section of Primary Care Mental Health, Health Services and Population Research Department, King's College London, London, UK.
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Rubio-Valera M, Chen TF, O'Reilly CL. New roles for pharmacists in community mental health care: a narrative review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:10967-90. [PMID: 25337943 PMCID: PMC4211017 DOI: 10.3390/ijerph111010967] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 09/30/2014] [Accepted: 10/07/2014] [Indexed: 02/05/2023]
Abstract
Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the pharmacists' role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to pharmacists' attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma.
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Affiliation(s)
- Maria Rubio-Valera
- Research and Development Unit, Fundació Sant Joan de Déu, Department of Pharmacology and Therapeutic Chemistry, School of Pharmacy, Universitat de Barcelona, Barcelona 08830, Spain.
| | - Timothy F Chen
- Faculty of Pharmacy, The University of Sydney, Sydney 2006, Australia.
| | - Claire L O'Reilly
- Faculty of Pharmacy, The University of Sydney, Sydney 2006, Australia.
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Perspective of community pharmacists on their practice with patients who have an antidepressant drug treatment: findings from a focus group study. Res Social Adm Pharm 2014; 11:e43-56. [PMID: 25443641 DOI: 10.1016/j.sapharm.2014.07.180] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 07/29/2014] [Accepted: 07/29/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND Around 2/3 of patients with major depression discontinue their antidepressant drug treatment (ADT) prematurely. Community pharmacists can rely on their regular contacts with patients to identify and support those experiencing difficulties with their ADT. OBJECTIVE The aim of this study is to describe pharmacists' perceptions with respect to their practices related to patients having an ADT. METHODS A qualitative study was conducted based on 6 focus groups involving 43 community pharmacists in 5 regions of Quebec province, Canada. Verbatim transcripts of focus groups were analyzed using computer-assisted thematic analysis. RESULTS The discussions revealed three major aspects of the participants' pharmacy practice: convincing patients to initiate ADT, dealing with side effects in the first weeks of the treatment, and taking a reactive approach to managing the treatment for the remainder of the follow-up. Discussions also enabled participants to identify the challenges they face concerning their practice with patients who have an ADT, and voice their recommendations for improving pharmacy practice and ultimately patient adherence to ADT. CONCLUSIONS Pharmacists wishing to help their patients to adequately manage their ADT face important barriers. Potential solutions include tools designed to help pharmacists better detect and intervene in ADT-related problems. Study findings will guide the on-going development of training and tools to support pharmacists' practice in this context.
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Knox K, Fejzic J, Mey A, Fowler JL, Kelly F, McConnell D, Hattingh L, Wheeler AJ. Mental health consumer and caregiver perceptions of stigma in Australian community pharmacies. Int J Soc Psychiatry 2014; 60:533-43. [PMID: 24062232 DOI: 10.1177/0020764013503149] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The stigma of mental illness can be a barrier to effective medication management in the community pharmacy setting. This article explored mental health consumers' or caregivers' experiences of stigma in Australian community pharmacies. MATERIALS Semi-structured interviews and focus groups were conducted with a purposive sample of consumers or caregivers (n = 74). Interview transcripts were analysed using a general inductive approach. DISCUSSION Stigma presented a barrier to effective mental health management. Self-stigma impeded consumers' community pharmacy engagement. Positive relationships with knowledgeable staff are fundamental to reducing stigma. CONCLUSIONS Findings provide insight into the stigma of mental illness in community pharmacies.
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Affiliation(s)
- Kathy Knox
- Griffith Health Institute, Griffith University, Brisbane, QLD, Australia
| | - Jasmina Fejzic
- Griffith Health Institute, Griffith University, Brisbane, QLD, Australia School of Pharmacy, Griffith University, Gold Coast, QLD, Australia
| | - Amary Mey
- School of Pharmacy, Griffith University, Gold Coast, QLD, Australia
| | - Jane L Fowler
- Griffith Health Institute, Griffith University, Brisbane, QLD, Australia
| | - Fiona Kelly
- Griffith Health Institute, Griffith University, Brisbane, QLD, Australia Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Denise McConnell
- School of Pharmacy, Griffith University, Gold Coast, QLD, Australia
| | - Laetitia Hattingh
- School of Pharmacy, Griffith University, Gold Coast, QLD, Australia Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, WA, Australia
| | - Amanda J Wheeler
- Griffith Health Institute, Griffith University, Brisbane, QLD, Australia Faculty of Medical and Health Sciences, University of Auckland, New Zealand
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Coppens E, Van Audenhove C, Iddi S, Arensman E, Gottlebe K, Koburger N, Coffey C, Gusmão R, Quintão S, Costa S, Székely A, Hegerl U. Effectiveness of community facilitator training in improving knowledge, attitudes, and confidence in relation to depression and suicidal behavior: results of the OSPI-Europe intervention in four European countries. J Affect Disord 2014; 165:142-50. [PMID: 24882192 DOI: 10.1016/j.jad.2014.04.052] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Community facilitators (CFs), such as teachers, nurses and social workers, are well placed as gatekeepers for depression and suicidal behavior, but not properly prepared to provide preventive and supportive services. The current study aimed: (1) to improve CFs' attitudes toward depression, knowledge on suicide, and confidence to detect suicidal behavior in four European countries and (2) to identify specific training needs across regions and CF groups. METHODS A standardized training program was provided to 1276 CFs in Germany, Hungary, Ireland, and Portugal. Attitudes toward depression, knowledge about suicide, and confidence in identifying suicidal persons were assessed before training, after training, and at three to six months follow-up. Additionally, several participants' characteristics were registered. RESULTS At baseline, CFs showed relatively favorable attitudes toward depression, but limited knowledge on suicide, and little confidence to identify suicidal behavior. Basic skills strongly differed across CF groups and countries. For example, in Germany, carers for the elderly, nurses, teachers, and managers were most in need of training, while in Portugal pharmacists and the clergy appeared to be important target groups. Most importantly, the training program improved the competencies of CF groups across countries and these improvements were sustained after three to six months. CFs with low basic skills benefited most of the training. LIMITATIONS The observed training effects could be influenced by other external factors as our results are based upon a pre-post comparison with no control group. CONCLUSIONS Gatekeeper trainings in community settings are successful in improving knowledge, reshaping attitudes, and boosting the confidence of gatekeepers. The most effective strategy to achieve the preferred objectives is to target those CF groups that are most in need of training and to tailor the content of the training program to the individual needs of the target group.
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Affiliation(s)
- Evelien Coppens
- LUCAS, Centre for Care Research and Consultancy, University of Leuven, Leuven, Belgium
| | - Chantal Van Audenhove
- LUCAS, Centre for Care Research and Consultancy, University of Leuven, Leuven, Belgium.
| | - Samuel Iddi
- Biostatistics and Statistical Bioinformatics Centre, University of Leuven, Leuven, Belgium; Department of Statistics, University of Ghana, Ghana
| | - Ella Arensman
- National Suicide Research Foundation & Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Katrin Gottlebe
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Nicole Koburger
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Claire Coffey
- National Suicide Research Foundation & Department of Epidemiology and Public Health, University College Cork, Cork, Ireland
| | - Ricardo Gusmão
- CEDOC, Departamento de Saúde Mental, Faculdade de Ciências Médicas da Universidade NOVA de Lisboa, Lisboa, Portugal; Serviço de Psiquiatria, Hospital de Egas Moniz, Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal
| | - Sónia Quintão
- CEDOC, Departamento de Saúde Mental, Faculdade de Ciências Médicas da Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Susana Costa
- CEDOC, Departamento de Saúde Mental, Faculdade de Ciências Médicas da Universidade NOVA de Lisboa, Lisboa, Portugal
| | - András Székely
- Institute of Behavioral Sciences, Semmelweis University Budapest, Budapest, Hungary
| | - Ulrich Hegerl
- Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany
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Van Daele T, Vansteenwegen D, Hermans D, Van den Bergh O, Van Audenhove C. Home nurses and patient depression. Attitudes, competences and the effects of a minimal intervention. J Adv Nurs 2014; 71:126-35. [DOI: 10.1111/jan.12476] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Tom Van Daele
- Policy Research Centre Welfare, Health and Family & Research Group on Health Psychology; University of Leuven; Belgium
- Applied Psychology Thomas More University College; Antwerp Belgium
| | - Debora Vansteenwegen
- Centre for the Psychology of Learning and Experimental Psychopathology; University of Leuven; Belgium
- ISW Limits; Leuven Belgium
| | - Dirk Hermans
- Centre for the Psychology of Learning and Experimental Psychopathology; University of Leuven; Belgium
| | | | - Chantal Van Audenhove
- Policy Research Centre Welfare, Health and Family & Research Group on Health Psychology; University of Leuven; Belgium
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Cannon-Breland ML, Westrick SC, Kavookjian J, Berger BA, Shannon DM, Lorenz RA. Pharmacist self-reported antidepressant medication counseling. J Am Pharm Assoc (2003) 2014; 53:390-9. [PMID: 23892812 DOI: 10.1331/japha.2013.12112] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To identify the extent of pharmacists' self-reported antidepressant counseling (SRAC) and to identify factors that may affect pharmacists' decisions to provide antidepressant counseling. DESIGN Cross-sectional study. SETTING Alabama community pharmacies in 2011. PARTICIPANTS Full-time pharmacists from 600 community pharmacies. INTERVENTION Self-administered survey; three mail contacts with alternate electronic surveys were used. MAIN OUTCOME MEASURES Pharmacists' SRAC behavior and its relationship with pharmacists' illness perceptions of depression, self-efficacy, and organizational and environmental influences. RESULTS 600 surveys were sent; 22 were undeliverable, 1 was partially completed (<80% questions answered), and 118 were completed (20.6% overall response rate). Pharmacists reported low rates of involvement in antidepressant counseling; 61% reported assessing patient knowledge and understanding of depression, and 36% discussed options for managing adverse effects with no more than a few patients. More than one-quarter (28.6%) never asked patients whether they had barriers to taking antidepressants. Pharmacists' perceptions regarding consequences, control/cure, and the episodic nature of depression, as well as their self-efficacy, had significant relationships ( P < 0.05) with pharmacists' involvement in antidepressant counseling. CONCLUSION Low rates of pharmacists' involvement in antidepressant counseling were reported. Pharmacists must become more involved in counseling patients about their antidepressant medications and overcoming barriers preventing greater involvement.
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Murphy A, Szumilas M, Rowe D, Landry K, Martin-Misener R, Kutcher S, Gardner D. Pharmacy students' experiences in provision of community pharmacy mental health services. Can Pharm J (Ott) 2014; 147:55-65. [PMID: 24494016 DOI: 10.1177/1715163513514170] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Little information is available describing the pharmacy student's experience working in community practice with people with lived experience of mental illness. Students' perspectives as observers, learners, technical staff and future pharmacists are important. OBJECTIVE To gain a better understanding of the pharmacy student experience in community pharmacy-based service provision to people with lived experience of mental illness. METHODS We conducted a qualitative study using interpretive description and application of the Theoretical Domains Framework. Focus groups were held with third- and fourth-year undergraduate pharmacy students from one Canadian university. RESULTS Two student focus groups were held in the fall of 2012 with 11 students (7 third year and 4 fourth year), 6 women and 5 men, mean age 24.5 (range, 21 to 30) years, averaging 3.2 years (range, 2 weeks to 7 years) of cumulative, mostly part-time, community pharmacy experience. Three broad themes emerged from the pharmacy student experience: (1) business tension; (2) roles, responsibilities and relationships; and (3) stigma. Students discussed their own roles, responsibilities and relationships in a pluralistic identity experience (i.e., pharmacy student, technician, future pharmacist). Application of the Theoretical Domains Framework demonstrated numerous influences on behaviour. CONCLUSIONS From the students' description of community pharmacy-based care of people with lived experience of mental illness, significant issues exist with current practices and behaviours. Advancing the role of pharmacists and pharmacy students to meet the needs of people with mental illness will require strategies to address multifactorial influences on behaviour.
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Affiliation(s)
- Andrea Murphy
- College of Pharmacy (Murphy, Gardner), Dalhousie University, Halifax, Nova Scotia
| | - Magdalena Szumilas
- College of Pharmacy (Murphy, Gardner), Dalhousie University, Halifax, Nova Scotia
| | - Denise Rowe
- College of Pharmacy (Murphy, Gardner), Dalhousie University, Halifax, Nova Scotia
| | - Kathryn Landry
- College of Pharmacy (Murphy, Gardner), Dalhousie University, Halifax, Nova Scotia
| | - Ruth Martin-Misener
- College of Pharmacy (Murphy, Gardner), Dalhousie University, Halifax, Nova Scotia
| | - Stan Kutcher
- College of Pharmacy (Murphy, Gardner), Dalhousie University, Halifax, Nova Scotia
| | - David Gardner
- College of Pharmacy (Murphy, Gardner), Dalhousie University, Halifax, Nova Scotia
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Mohamed SS, Mahmoud AA, Ali AA. The role of Sudanese community pharmacists in patients' self-care. Int J Clin Pharm 2014; 36:412-9. [PMID: 24442644 DOI: 10.1007/s11096-013-9911-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 12/29/2013] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To describe the current and potential roles of Sudanese community pharmacists in responding to symptoms (RTS) and chronic diseases management (CDM) and identify perceived barriers. SETTINGS Community pharmacies in Khartoum State. METHOD A structured, self-administered, piloted questionnaire was conducted of pharmacists in charge of 274, randomly selected, community pharmacies. Close ended questions and a 5-point Likert-type scale were used to measure responses. MAIN OUTCOME MEASURE Respondents' demographics, their current activities, attitude and involvement in RTS and CDM and potential barriers. Response rate was 67 %. The majority of respondents (>90 %) reported that they are involved in RTS activities but have negative views regarding practice standards. They lack specific lists of minor conditions and their treatment (87.4 %), recorded counseling procedure (84.7 %), and referral forms (85.8 %). Almost all community pharmacists see an important role for them in CDM (4.54 ± 0.74, 95.3 %) and accept team work with other health care providers (4.46 ± 0.74, 87.5 %). Lack of proper knowledge and training, time, space, patients' acceptance and official recognition of pharmacists' new role, were some of the identified barriers. CONCLUSION Sudanese community pharmacists provide RTS and CDM services; however, clinical knowledge and training and well defined national practice standards needs were identified. The current product-focused activities need to be refined to include more patient-focused services. For Improved patients' self-care services, a number of obstacles identified by surveyed pharmacists need to resolved. This requires collaboration of different parties including academics, governmental bodies and professional organizations.
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Affiliation(s)
- Sumia S Mohamed
- Department of Pharmaceutics, College of Pharmacy and Health Sciences, Ajman University of Science and Technology Network, Fujairah Campus, Box 2202, Al Fujairah, Ajman, UAE,
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Mey A, Fowler JL, Knox K, Shum DHK, Fejzic J, Hattingh L, McConnell D, Wheeler A. Review of community pharmacy staff educational needs for supporting mental health consumers and carers. Community Ment Health J 2014; 50:59-67. [PMID: 23306675 DOI: 10.1007/s10597-012-9580-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Accepted: 12/25/2012] [Indexed: 10/27/2022]
Abstract
Development of a mental health education package for community pharmacy staff should be informed by mental health consumers/carers' needs, expectations and experiences, and staff knowledge, skills and attitudes. This review (1) explored research on community pharmacy practice and service provision for mental health consumers/carers, and (2) identified validated methods for assessing staff knowledge, skills and attitudes about mental illness to inform the development of a training questionnaire. A literature scan using key words knowledge, skills, attitudes, and beliefs combined with community pharmacy, pharmacist, and pharmacy support staff, and mental illness, depression, anxiety was conducted. A small number of studies were found that used reliable methods to assess pharmacists' training needs regarding mental illness and treatment options. There was little published specifically in relation to depression and anxiety in community pharmacy practice. No studies assessed the training needs of pharmacy support staff. A systematic analysis of pharmacy staff learning needs is warranted.
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Affiliation(s)
- Amary Mey
- School of Pharmacy, Griffith University, Gold Coast, 4222, Australia,
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Liekens S, Smits T, Laekeman G, Foulon V. A depression training session with consumer educators to reduce stigmatizing views and improve pharmacists' depression care attitudes and practices. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2013; 77:120. [PMID: 23966723 PMCID: PMC3748301 DOI: 10.5688/ajpe776120] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 02/06/2013] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To measure the impact of a depression training day for pharmacists that included a 75-minute session with a consumer educator. DESIGN The training day included interactive lectures on depression; the effects and side effects of and indications for the use of antidepressants; adherence issues; non-drug treatment options for depression; and basic skills in communication. Pharmacists also participated in a session with a consumer educator and in counseling exercises that included role playing. ASSESSMENT The study used a randomized, clustered, comparative design to measure pharmacists' stigma, attitudes, and current practice related to the provision of pharmaceutical care to people with depression. Mean scores for depression-care practice after the training session were significantly higher in the intervention group than in the control group. Analysis of the changes between baseline and postintervention measures in both the control and intervention groups confirmed a significant difference in the change in both social distance and practice but no significant difference in the change in attitude between the 2 groups of pharmacists. CONCLUSION A continuing-education depression training day for pharmacists that involve consumer educators may improve the care delivered in the community pharmacy to people with depression.
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Affiliation(s)
- Sophie Liekens
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium.
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Wheeler A, Fowler J, Hattingh L. Using an intervention mapping framework to develop an online mental health continuing education program for pharmacy staff. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2013; 33:258-66. [PMID: 24347104 DOI: 10.1002/chp.21198] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Current mental health policy in Australia recognizes that ongoing mental health workforce development is crucial to mental health care reform. Community pharmacy staff are well placed to assist people with mental illness living in the community; however, staff require the knowledge and skills to do this competently and effectively. This article presents the systematic planning and development process and content of an education and training program for community pharmacy staff, using a program planning approach called intervention mapping. METHODS The intervention mapping framework was used to guide development of an online continuing education program. Interviews with mental health consumers and carers (n = 285) and key stakeholders (n = 15), and a survey of pharmacy staff (n = 504) informed the needs assessment. Program objectives were identified specifying required attitudes, knowledge, skills, and confidence. These objectives were aligned with an education technique and delivery strategy. This was followed by development of an education program and comprehensive evaluation plan. The program was piloted face to face with 24 participants and then translated into an online program comprising eight 30-minute modules for pharmacists, 4 of which were also used for support staff. The evaluation plan provided for online participants (n ≅ 500) to be randomized into intervention (immediate access) or control groups (delayed training access). It included pre- and posttraining questionnaires and a reflective learning questionnaire for pharmacy staff and telephone interviews post pharmacy visit for consumers and carers. RESULTS An online education program was developed to address mental health knowledge, attitudes, confidence, and skills required by pharmacy staff to work effectively with mental health consumers and carers. DISCUSSION Intervention mapping provides a systematic and rigorous approach that can be used to develop a quality continuing education program for the health workforce.
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Affiliation(s)
- Amanda Wheeler
- Professor Mental Health, Griffith Health Institute, Griffith University; Clinical Associate Professor, Faculty of Medical and Health Sciences, University of Auckland.
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Wang YH, Huang HC, Liu SI, Lu RB. Assessment of changes in confidence, attitude, and knowledge of non-psychiatric physicians undergoing a depression training program in Taiwan. Int J Psychiatry Med 2012; 43:293-308. [PMID: 23094463 DOI: 10.2190/pm.43.4.a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess whether non-psychiatric physicians would benefit from a national depression training program and explore associated factors. METHOD Attending physicians were asked to complete survey questionnaires of confidence, attitude, knowledge, and their willingness to implement new strategies to improve care, before and after training. Paired t-test and multiple regression analysis were used to determine the differences and explore factors associated with the domains of confidence, attitude, and knowledge. McNemar's test was used to compare the difference between the physicians' intention to change depression management before and after training. RESULTS Of 524 eligible physicians, 307 (59%) completed the pre- and post-program assessments. These physicians showed significantly increased knowledge score and willingness to implement new treatment strategies, as well as more positive attitude toward and confidence in treating depression. The lower corresponding baseline score was associated with greater improvement in domains ofknowledge, confidence, and attitude. Completion of the training was associated with an improvement in knowledge and becoming less helpless and avoidant attitude. Other factors including non-family-medicine physicians, post-graduate education, and female gender are associated with greater improvements in various domains. CONCLUSIONS Our study shows that even a brief educational program can positively influence the physicians' knowledge, attitudes, and confidence in treating depression. Further work is needed to monitor whether the effects of training are long-term, and can be translated into behavioral change in practice.
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Affiliation(s)
- Yao-Hsien Wang
- Department of Psychiatry, Buddhist Tzu-Chi General Hospital, Taipei Branch, Taipei, Taiwan
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Liekens S, Smits T, Laekeman G, Foulon V. Pharmaceutical care for people with depression: Belgian pharmacists’ attitudes and perceived barriers. Int J Clin Pharm 2012; 34:452-9. [DOI: 10.1007/s11096-012-9628-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Accepted: 03/16/2012] [Indexed: 10/28/2022]
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Haddad M, Menchetti M, Walters P, Norton J, Tylee A, Mann A. Clinicians' attitudes to depression in Europe: a pooled analysis of Depression Attitude Questionnaire findings. Fam Pract 2012; 29:121-30. [PMID: 21926052 DOI: 10.1093/fampra/cmr070] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Depression in primary care is common but under-recognized and suboptimally managed. Health professionals' attitudes are likely to play an important part in their recognition and management of depression. OBJECTIVES To pool findings from studies using the Depression Attitude Questionnaire (DAQ) to provide greater detail of clinicians' attitudes and the measure's psychometric properties. METHODS Electronic databases and grey literature were searched for relevant studies. Data from eligible studies were requested and pooled analysis conducted. RESULTS Twenty studies were eligible and data were obtained from 12 of these involving GPs (n = 1543) and nurses (n = 984). Responses showed strong disagreement that depression is due to ageing or weakness. European GPs were more positive about depression treatments than UK GPs; nurses were more favourable about psychotherapy than GPs. UK GPs especially strongly opposed notions that depression is best managed by psychiatrists. Trends over time indicated increasing acknowledgement of psychological therapies and the nurse's role in depression management. Factor analysis indicated that many DAQ items fitted weakly within an overall model. The most parsimonious solution involved two factors: a positive view of depression and its treatment response and professional confidence in depression management. CONCLUSIONS Individual DAQ items appear to measure key aspects of clinicians' attitudes to depression, and item responses indicate important differences between professions and geographical settings as well as changes over time. There are problems with the DAQ as a scale: its internal consistency is weak, and several items appear specific to particular professions or service structures, indicating that this questionnaire should be revised.
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Affiliation(s)
- M Haddad
- Section of Primary Care Mental Health, Health Service and Population Research Department, Institute of Psychiatry at King's College London, London SE5 8AF, UK.
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Mental health consumers and caregivers as instructors for health professional students: a qualitative study. Soc Psychiatry Psychiatr Epidemiol 2012; 47:607-13. [PMID: 21384120 DOI: 10.1007/s00127-011-0364-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 02/21/2011] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this study was to explore the self-reported effect of consumer and caregiver-led education for pharmacy students and to explore the goals, challenges and benefits of mental health consumer educators providing education to health professional students. METHODS Five focus groups (mean duration 46 min, SD 22 min) were held with 23 participants (11 undergraduate pharmacy students, 12 mental health consumer educators) using semi-structured interview guides. The focus groups were digitally audio-recorded, transcribed verbatim and thematically content analyzed using a constant comparison approach. RESULTS Three major themes emerged from the data; raising awareness about mental health, impact on professional practice and impact on mental health consumers. The students reported decreased stigma, improved attitudes toward mental illness and behavior changes in their professional practice. The primary reason for becoming an educator was to raise awareness and reduce mental health stigma. However, educators also benefited personally through empowerment, improved confidence and social skills. CONCLUSION Providing students the opportunity to have contact with consumers with a mental illness in a safe, educational setting led to decreases in stigma, the fostering of empathy and self-reported behavior changes in practice. Sharing personal stories about mental illness is a powerful tool to decrease mental health stigma and may be an important aspect of a person's recovery from mental illness. Contact with mental health consumers in an educational setting is recommended, particularly for future health care professionals. Appropriate training and support of consumers is crucial to ensure the experience is positive for all involved.
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D'Incau P, Barbui C, Tubini J, Conforti A. Stressful life events and social health factors in women using anxiolytics and antidepressants: an Italian observational study in community pharmacies. ACTA ACUST UNITED AC 2011; 8:80-92. [PMID: 21536227 DOI: 10.1016/j.genm.2011.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND In Italy, as in all of Europe, women differ from men in that they are somewhat more sensitive to the depressogenic effects of stressful life events related to their social networks and emotional sphere. Women are more likely than men to have experienced poverty, gender discrimination, and physical and sexual abuse. OBJECTIVE The purpose of this study was to expand the knowledge about the occurrence of stressful life events in women exposed and not exposed to anxiolytics and antidepressants in a community pharmacy setting. METHODS Women attending 100 community pharmacies in the Italian Veneto region were surveyed by pharmacists with regard to a number of general features of their current pharmacologic treatment. Women independently completed a written self-assessment questionnaire that focused on stressful life events. Unconditional logistic regression analysis was performed to investigate the association between anxiolytics and antidepressants use and potential factors, including stressful life events. RESULTS The study population comprised 11,357 women. One or more stressful life events occurred in 90% of the women treated with anxiolytics and/or antidepressants (users [n = 3848]) and in 74% of the women not treated with these drugs (nonusers [n = 7509]) (odds ratio = 3.19; 95% CI, 2.83-3.60). On average, the life events occurred during the previous 6 months and the women considered the influence of these events on their well-being to be severe. After the unconditional logistic regression analysis, the association between anxiolytics and/or antidepressants use remained positive for most of the stressful life events studied as well as for other factors: separation/divorce, living alone or with others (family or friends), unemployment, whether currently being seen by a psychologist/psychiatrist, and treatment with drugs for the alimentary tract and metabolism, cardiovascular system, or nervous system. CONCLUSIONS A significant association between stressful life events and anxiolytics and/or antidepressants use was observed. Further efforts are needed to increase our knowledge of the use of anxiolytics or antidepressants in relation to the occurrence of life events.
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Affiliation(s)
- Paola D'Incau
- Department of Community Medicine and Public Health, Section of Clinical Pharmacology Unit, University of Verona, Verona, Italy.
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O'Reilly CL, Bell JS, Chen TF. Pharmacists' beliefs about treatments and outcomes of mental disorders: a mental health literacy survey. Aust N Z J Psychiatry 2010; 44:1089-96. [PMID: 21070104 DOI: 10.3109/00048674.2010.512864] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To assess the beliefs of pharmacists about the helpfulness of interventions for schizophrenia and depression. METHODS A survey instrument containing a measure of mental health literacy was mailed to a random sample of 2000 pharmacists registered with the Pharmacy Board of New South Wales in November 2009. Vignettes of a person with either depression or psychosis were presented, followed by questions related to the recognition of the disorder, the helpfulness of various interventions, prognosis with and without professional help, the person's long-term functioning in various social roles and the likelihood of the person being discriminated against. RESULTS A total of 391 responses were received (response rate 19.5%). The majority of pharmacists correctly identified depression (92%) with fewer recognizing schizophrenia (79%). Pharmacists rated medicine use highly for both schizophrenia and depression but were also positive about the use of psychological therapies and lifestyle interventions. Pharmacists had negative views about admission to a psychiatric ward and the use of electroconvulsive therapy (ECT). However, younger pharmacists had significantly more positive views on the use of ECT (p = 0.001). The majority of pharmacists (74%) thought discrimination by the community was highly likely and rated long-term prognosis as poor without appropriate professional help. Their views on the likelihood of specific negative outcomes were mixed, with many pharmacists not recognizing the risk of suicide in schizophrenia and depression. However, both female (p = 0.002) and younger pharmacists (p < 0.001) were significantly more inclined to rate the likelihood of suicide as more likely in a person with schizophrenia or depression. CONCLUSIONS The majority of pharmacists had a high degree of mental health literacy as indicated by the correct identification of, and support for evidence-based interventions for mental illnesses. Pharmacists should be aware that their attitudes and stigma towards mental illness may impact on the patient care they provide.
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O'Reilly CL, Bell JS, Chen TF. Consumer-led mental health education for pharmacy students. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2010; 74:167. [PMID: 21301601 PMCID: PMC2996757 DOI: 10.5688/aj7409167] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 06/11/2010] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To evaluate a consumer-led teaching intervention to reduce pharmacy students' stigma towards depression and schizophrenia, and improve attitudes toward providing pharmaceutical care for consumers with mental illness. DESIGN Third-year bachelor of pharmacy degree students were given a series of mental health lectures, undertook supervised weekly placements in the community pharmacy setting, and attended a tutorial led by trained mental health consumer educators. ASSESSMENT A previously validated 26-item survey instrument was administered at baseline, 6 weeks postintervention, and 12 months postintervention, and 3 focus groups were conducted. Survey instruments were completed by 225 students at baseline, 230 students postintervention, and 228 students at 12 months. Students' stigma decreased (p < 0.05) and their attitudes toward the provision of pharmaceutical services to consumers with a mental illness showed significant improvements (p < 0.05). These improvements were maintained at the 12-month follow-up. Four themes emerged from the focus groups: knowledge and experience of mental illness, mental health stigma, impacts on attitudes and self-reported behavior, and the role of the pharmacist in mental healthcare. CONCLUSIONS Consumer-led education for pharmacy students may provide a sustainable reduction in stigma and improve attitudes towards providing pharmaceutical services to consumers with a mental illness.
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Affiliation(s)
- Claire L O'Reilly
- Faculty of Pharmacy, The University of Sydney, New South Wales, Australia.
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Panthee S, Panthee B, Shakya SR, Panthee N, Bhandari DR, Bell JS. Nepalese pharmacy students' perceptions regarding mental disorders and pharmacy education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2010; 74:89. [PMID: 20798796 PMCID: PMC2907854 DOI: 10.5688/aj740589] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Accepted: 11/08/2009] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To determine Nepalese pharmacy students' perceptions of whether mental disorders impact performance in pharmacy school. METHOD All first- and third-year undergraduate pharmacy students (n=226) in Nepal were invited to complete a modified version of the Mental Illness Performance Scale. RESULTS Among the 200 respondents (response rate 88.5%), 14% reported that they had a mental disorder. The majority (92%) of third-year students agreed or strongly agreed that depression would interfere with a student's academic performance. Almost half of first-year students agreed or strongly agreed that alcohol or drug abuse would be grounds for both rejecting an applicant from pharmacy school (49%) and dismissal of a student from pharmacy school (46%). CONCLUSIONS Students perceived a high level of academic impairment associated with mental disorders, but the majority did not perceive that mental disorders were grounds for dismissal from or rejection of entry to pharmacy school. Students' attitudes may discourage them from seeking help or providing mental health support to others.
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Affiliation(s)
- Suresh Panthee
- Department of Pharmacy, Kathmandu University, Nepal
- School of Biomedical Sciences, Tokyo Medical and Dental University, Japan
| | - Bimala Panthee
- School of Nursing, Prince of Songkla University, Songkla, Hat Yai, Thailand
| | - Sabin Raj Shakya
- School of Pharmaceutical and Biomedical Sciences, Pokhara University, Nepal
| | - Nirmal Panthee
- Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Dhaka Ram Bhandari
- School of Pharmaceutical and Biomedical Sciences, Pokhara University, Nepal
| | - J Simon Bell
- Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Finland
- Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Finland
- Faculty of Pharmacy, University of Sydney, Australia
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