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PSYCHIATRY

Patients' Perceptions of Information Received at the Start of Selective Serotonin-Reuptake Inhibitor Treatment: Implications for Community Pharmacy

Researcher, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, Netherlands

Martine Kruijtbosch, MSc

Researcher, SIR Institute for Pharmacy Practice and Policy, Leiden, Netherlands

Antoine CG Egberts, PharmD PhD

Professor of Clinical Pharmacoepidemiology, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University; Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht

Eibert R Heerdink, PhD

Assistant Professor of Pharmacoepidemiology, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University

Rolf van Hulten, PharmD PhD

Researcher, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University

Reprints: Dr. van Geffen, Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, PO Box 80082, 3508 TB, Utrecht, the Netherlands, fax 31 30 253 9166, e.c.g.vangeffen{at}uu.nl

BACKGROUND: Pharmacists are increasingly acknowledging their responsibility to inform and counsel patients. However, it is unclear how these tasks are implemented and whether patients' needs are being fulfilled.

OBJECTIVE: To examine patients' perceptions of information received at the start of selective serotonin-reuptake inhibitor (SSRI) treatment, aiming to identify (1) information needs and (2) the potential role of the community pharmacist as information provider.

METHODS: A qualitative descriptive study comprising semi-structured telephone interviews was carried out with patients who had recently started a new course of SSRI treatment. Patients were recruited through 6 Dutch community pharmacies. The interviews were guided by the following topics: type of information obtained, unmet information needs, preferred information provider, and the role of the pharmacist.

RESULTS: Forty-one patients took part in an interview. Information needs varied widely among patients; overall, patients felt that they would benefit from information tailored to their needs. Many patients required more concrete and practical information on adverse effects and delayed onset of action than was provided. In addition, an explanation of the term dependency in the context of SSRI use and a discussion of the necessity for use and believed harms of long-term treatment were important to patients. Regardless of patients' needs, the role of the pharmacist was generally perceived as limited, and patients identified several pharmacy-related barriers to improved communication, including the timing of information (mainly restricted to first-time dispensing), lack of time and privacy, lack of empathy and a protocol-driven way of providing information, and inexperience of pharmacy technicians.

CONCLUSIONS: Patients starting treatment with antidepressants may benefit from information tailored to their personal needs. Along with the prescribing physician, community pharmacists could have an important role in informing and counseling patients.

Key Words: counseling, education, pharmacy, selective serotonin-reuptake inhibitors

Published Online, March 24, 2009. www.theannals.com, DOI 10.1345/aph.1L393