The Role of Pharmacists in Detecting Depression Among Patients

The US Preventive Services Task Force (USPSTF) recently updated its recommendations for depression screening in adults.

According to the USPSTF, major depressive disorder is the leading cause of disability among adults in high-income countries. When left untreated, depression can become chronic and refractory.

The USPSTF recommends that screening for depression can ultimately help reduce or eliminate depression symptoms, lower the need for related health care services, and improve the health of pregnant or postpartum patients with depression.

Risk factors for depression in pregnant or postpartum women, which are distinct from those associated with depression in other patient populations, include child-care stress, prenatal anxiety, single/unpartnered relationship status, difficult infant temperament, previous postpartum depression, and unintended pregnancy.

Although the USPSTF didn’t endorse a specific screening method, evidence from previous research suggests that pharmacists, as members of a collaborative care team, can play an important role in depression screening services.

One way in which pharmacists can contribute to depression screenings is to monitor patients taking medication regimens that may predispose them to depression symptoms. For example, research published in the February 2015 issue of Pain found that dispensing higher opioid doses to chronic pain patients could trigger depression.

Jeffery F. Scherrer, PhD, lead author of the Pain study, previously told Pharmacy Times that each pharmacy visit is an opportunity to educate the patient, and that pharmacists can “communicate in print or verbally that their patients should be aware of any changes in mood while taking their opioid analgesic.”

Beyond medication reviews, pharmacists’ accessibility may help patients who might otherwise avoid seeking help because of the social stigma of mental health issues. Pharmacists may be able to recognize symptoms of depression and other illnesses, and previous research has found that pharmacists trained with the proper skills and knowledge can identify and support patients with depression.

Of note, the USPSTF’s updated recommendations emphasize both newer-generation antidepressants and empirically supported psychotherapies either alone or in combination.

“If the clinicians working within a collaborative care model could rapidly incorporate the information that an initial prescription was not filled or was not refilled, it may be possible to diminish the chances that nonadherence will compromise treatment outcome,” postulated Michael E. Thase, MD, author of an editorial corresponding with the updated USPSTF recommendations.

The depression screening recommendations published online in the Journal of the American Medical Association on January 26, 2016, updates the task force’s 2009 and 2002 recommendations.