Table 2.
Content of pharmacist consultations (n = 20 visits) in scenario 2
| Content of information | n | % of visits |
|---|---|---|
| Information gathering | ||
| Who the product (st John’s wort) is for | 5 | 25 |
| If the patient has sought medical help for depression or is already taking an antidepressant | 14 | 70 |
| How is the patient taking the antidepressant (eg, dose/timing)* | 10 | 50 |
| How long has the patient been taking the antidepressant | 18 | 90 |
| Probe on patient’s main concern about lack of improvement in symptoms (eg, questions on current depression symptoms)* | 12 | 60 |
| Probe for patient’s other concerns and barriers to using the antidepressant (such as side effects)* | 8 | 40 |
| If the patient takes any other medications in addition to the antidepressant | 5 | 25 |
| Information provision | ||
| Use of St John’s wort | ||
| Information about use of St John’s wort in depression | 19 | 95 |
| Interaction | ||
| Precaution about use of St John’s wort together with antidepressants (risk of serotonin toxicity) | 18 | 90 |
| Information on switching fluoxetine to another antidepressant/St John’s wort | 4 | 20 |
| Timeframe of treatment | ||
| Time to onset of effects for antidepressants* | 18 | 90 |
| Expected duration of antidepressant treatment* | 2 | 10 |
| Adherence messages | ||
| Take antidepressant on a daily basis* | 3 | 15 |
| Information resources | ||
| Provides written information about St John’s wort/depression | 3 | 15 |
| Recommendations of information sources (eg, websites) | 4 | 20 |
| Nonpharmacologic management | ||
| Discussions of lifestyle and psychosocial activities or stressors related to depression* | 4 | 20 |
| Discussions of nonpharmacologic alternatives (eg, counseling or psychotherapy) | 7 | 35 |
| Treatment recommendations | ||
| Provides advice to persist with antidepressant treatment* | 14 | 70 |
| Provides advice to go to the general practitioner if still no improvement in symptoms | 18 | 90 |
| Provides reassurance of the availability of other antidepressants as treatment alternatives | 8 | 40 |
| Provides recommendations for over-the-counter products to help with symptom (eg, sleeplessness) management | 5 | 25 |
| Advise patient to return to the pharmacy if any further questions or concerns | 4 | 20 |
Note:
*
Information shown by previous studies to be associated with improved antidepressant medication adherence.