EVALUATION AND IMPACT OF PHARMACIST INTERVENTION ON PATIENTS WITH DEPRESSION IN A TERTIARY CARE HOSPITAL OF HYDERABAD, PAKISTAN.

Abstract

Background:
Depression is a leading cause of disability worldwide and a growing public health challenge in low- and middle-income countries, including Pakistan. High prevalence, coupled with poor treatment adherence and limited specialist availability, underscores the need for innovative care models. Pharmacist-led interventions may offer a feasible solution for improving outcomes.

Objectives:
To evaluate the prevalence and severity of depression, identify associated demographic and lifestyle factors and assess the impact of pharmacist-led counseling on depressive symptoms and medication adherence.

Methods:
The study was conducted at Liaquat University Hospital, a tertiary care teaching hospital in Hyderabad, Pakistan. A total of 670 patients were screened using the PHQ-9 scale, of whom 377 were identified with depression. Data on demographics, clinical variables and adherence were collected at baseline. Pharmacist counseling sessions focused on education, medication adherence and lifestyle modification. Outcomes were assessed using PHQ-9 and adherence scores before and after intervention. Statistical analyses included chi-square tests, paired t-tests and McNemar’s test, with significance set at p<0.05.

Results:
Depression was diagnosed in 56.3% of patients, with severity distributed as mild (23.1%), moderate (25.5%) and severe (51.5%). Significant associations were observed with female gender, middle age, unemployment, smoking and inpatient status. The mean PHQ-9 score decreased from b post-intervention (p<0.001; Cohen’s d=0.52). Severe cases reduced from 51.5% to 23.6% while 9.0% achieved remission. Inpatients showed greater improvement than outpatients (–3.4 vs –2.1 points, both p<0.001). Medication adherence improved from 47.8% to 71.3%, with significant gains across all severity levels (p<0.001).

Conclusion:
Pharmacist intervention positively impacted depressive symptoms and medication adherence in patients in a tertiary care hospital. These outcomes point to the importance of embedding pharmacists in multidisciplinary teams in mental care to cover these gaps in the treatment of resources in the low-resource environment.