***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The object of the study was to evaluate outcomes of a r and omized clinical trial ( RCT ) of a pharmacist intervention for depressed patients in primary care ( PC ) . We report  antidepressant ( AD ) use and depression severity outcomes at 6-months . The RCT was conducted between 1998 and 2000 in 9 eastern Massachusetts PC practice s. We studied 533 patients with major depression and /or dysthymia as determined by a screening test done at the time of a routine PC office visit . The majority of participants had recurrent depressive episodes ( 63.5 % with > /=4 lifetime episodes ) , and 49.5 % were taking AD medications at enrollment . Consultation in person and by telephone was performed by a clinical pharmacist who assisted the primary care practitioner ( PCP ) and patient in medication choice , dose , and regimen , in accordance with AHCPR depression guidelines . Six-month AD use rates for intervention patients exceeded controls ( 57.5 % vs. 46.2 % , P = .03 ) . Furthermore , the intervention was effective in improving AD use rates for patients not on ADs at enrollment ( 32.3 % vs. 10.9 % , P = .001 ) . The pharmacist intervention proved equally effective in subgroups traditionally considered difficult to treat : those with chronic depression and dysthymia . Patients taking ADs had better modified Beck Depression Inventory ( mBDI ) outcomes than patients not taking ADs , ( -6.3 points change , vs. -2.8 , P = .01 ) but the outcome differences between intervention and control patients were not statistically significant ( 17.7 BDI points vs. 19.4 BDI points , P = .16 ) . Pharmacists significantly improved rates of AD use in PC patients , especially for those not on ADs at enrollment , but outcome differences were too small to be statistically significant . Difficult-to-treat subgroups may benefit from pharmacists ' care BACKGROUND Patients with chronic forms of major depression are difficult to treat , and the relative efficacy of medications and psychotherapy is uncertain . METHODS We r and omly assigned 681 adults with a chronic nonpsychotic major depressive disorder to 12 weeks of outpatient treatment with  nefazodone ( maximal dose , 600 mg per day ) , the cognitive behavioral- analysis system of psychotherapy ( 16 to 20 sessions ) , or both . At base line , all patients had scores of at least 20 on the 24-item Hamilton Rating Scale for Depression ( indicating clinical ly significant depression ) . Remission was defined as a score of 8 or less at weeks 10 and 12 . For patients who did not have remission , a satisfactory response was defined as a reduction in the score by at least 50 percent from base line and a score of 15 or less . Raters were unaware of the patients ' treatment assignments . RESULTS Of the 681 patients , 662 attended at least one treatment session and were included in the analysis of response . The overall rate of response ( both remission and satisfactory response ) was 48 percent in both the nefazodone group and in the psychotherapy group , as compared with 73 percent in the combined-treatment group . ( P<0.001 for both comparisons ) . Among the 519 subjects who completed the study , the rates of response were 55 percent in the nefazodone group and 52 percent in the psychotherapy group , as compared with 85 percent in the combined-treatment group ( P<0.001 for both comparisons ) . The rates of withdrawal were similar in the three groups . Adverse events in the nefazodone group were consistent with the known side effects of the drug ( e.g. , headache , somnolence , dry mouth , nausea , and dizziness ) . CONCLUSIONS Although about half of patients with chronic forms of major depression have a response to short-term treatment with either nefazodone or a cognitive behavioral- analysis system of psychotherapy , the combination of the two is significantly more efficacious than either treatment alone OBJECTIVE The Medicare Hospital Readmissions Reduction Program ( MHRRP ) which took effect on October 1st , 2012 holds providers accountable for quality of care delivered , placing a greater focus on care coordination . Innovative strategies in medication management in the acute care and outpatient primary care setting s require vigilant pharmacist intervention . The objective of this study is to determine if pharmacist-provided medication reconciliation service in conjunction with hospital follow-up outpatient physician visits reduces hospital readmission rate . METHODS This was a prospect i ve study in which physician-initiated outpatient hospital follow-up appointment scheduling was used to identify patients at time of hospital discharge . All patients ≥50 years of age were eligible for outpatient pharmacist visits . Emergency room visits were excluded . Data collected included : patient demographics , characteristics of identified drug therapy problems , accuracy of outpatient medication histories and time required by pharmacist to perform the review s. Patient adherence to early ( 24 - 72 hours ) outpatient hospital follow-up visit was also evaluated . Previous year 's readmission data for high risk patients who received only physician visits were also collected for comparison with those who were jointly visited by pharmacists and physicians . RESULTS A total of 98 patients were assigned to receive pharmacist intervention in conjunction with  physician hospital follow-up visits . Nine of the 98 patients seen by pharmacists at hospital follow-up visits were readmitted ( 9.2 % ) to a hospital within 30 days of discharge . Out of the 236 patients seen during the same period the previous year ( 2011 ) for physician alone hospital follow-up visits 46 were readmitted ( 19.4 % ) within 30-days of hospital discharge . The difference between these groups was statistically significant ( p = 0.023 ) , with patients in the pharmacist intervention group experiencing a reduction in 30-day readmission risk . Physician alone outpatient follow-up was associated with earlier mean time to readmission , 12.8 days vs. 18.3 days in the pharmacist intervention group ( p = 0.042 ) . CONCLUSION Pharmacist involvement in hospital discharge follow-up visits reduced overall readmission rate in high risk patients and improved monitoring of drug therapy , and medication history accuracy when compared to physician-alone visits Background Adherence to antidepressant treatment is essential for the effective management of patients with major depressive disorder . Adherence to medication is a dynamic decision-making process , and pharmacists play an important role in improving adherence to antidepressant treatment in different setting s within the healthcare system . The aim of this study was to assess whether pharmacist interventions based on shared decision making improved adherence and patient-related outcomes . Methods This was a r and omised controlled study with a 6-month follow-up . Participants were r and omly allocated to two groups : 1 ) intervention group ( IG ) ( usual pharmacy services plus pharmacist interventions based on shared decision making ) ; or 2 ) control group ( CG ) ( usual pharmacy services ) .  Recruited patients fulfilled the following inclusion criteria : aged 18 to 60 years diagnosed with a major depressive disorder , and no history of psychosis or bipolar disorders . A research assistant blinded to the group allocations collected all data . Results Two hundred and thirty-nine patients met the inclusion criteria and were r and omised to the IG ( n = 119 ) or CG ( n = 120 ) . Nineteen patients dropped out of the study during the follow-up phase . After 6 months , patients in the IG had significantly more favorable medication adherence , treatment satisfaction , general overuse beliefs , and specific concern beliefs . However , the groups did not differ in severitye of depression or health-related quality of life after 6 months . Conclusions Our findings emphasise the important role of pharmacists in providing direct patient care in regular pharmacy practice to improve adherence to medications and other patient-reported outcomes .Trial registration IS RCT N34879893 , Date assigned : OBJECTIVE Non-compliance presents a constant challenge to effective therapy . Many studies only investigate early treatment discontinuation and not other measures like adherence to treatment regimen . We compared adherence in depressed patients using either a selective serotonin reuptake inhibitor ( fluoxetine ) or a tricyclic antidepressant ( amitriptyline )  , and examined its clinical relevance through adverse events , drop-out rates , and outcome . Adherence was measured electronically with the MEMS ( Medication Event Monitoring System ) . DESIGN Nine-week double blind , r and omized controlled trial . SETTING Ambulatory psychiatric care . PATIENTS R and om sample of 66 depressed ( DSM-III-R criteria ) patients . INTERVENTION Fluoxetine 20 mg or amitriptyline 150 mg . MAIN OUTCOME MEASURES Time course of adherence and its relation to severe adverse events , drop-outs and outcome . RESULTS Non-adherence to the treatment regimen occurred frequently in both treatment groups : 31 % of patients had at least one 3-day drug holiday , and 34 % of patients had at least one episode of three pills in a 24-h period . Over-consumption occurred more frequently during the early phases of treatment while under-consumption occurred more frequently during the later phases . Patients on amitriptyline ( P=0.03 ) and patients with a higher pill intake ( P=0.01 ) experienced more severe adverse events . Patients on amitriptyline ( P=0.009 ) and patients with a lower adherence to the treatment regimen ( P=0.004 ) discontinued from treatment more frequently . The final Hamilton score was significantly predicted by a longer duration of treatment and by a better adherence , but only in amitriptyline users . CONCLUSIONS Non-adherence to the treatment regimen has important clinical consequences . Pharmacodynamics and human behavior predict risk for severe adverse events and drop-outs . Moreover , in amitriptyline users but not in fluoxetine users , better adherence predicts a better outcome Major depression is associated with high burden , disability and costs . Non-adherence limits the effectiveness of antidepressants . Community pharmacists ( CP ) are in a privileged position to help patients cope with antidepressant treatment . The aim of the study was to evaluate the impact of a CP intervention on primary care patients who had initiated antidepressant treatment . Newly diagnosed primary care patients were r and omised to usual care ( UC ) ( 92 ) or pharmacist intervention ( 87 ) . Patients were followed up at 6 months and evaluated three times ( Baseline , and at 3 and 6 months ) . Outcome measurements included clinical severity of depression ( PHQ-9 ) , health-related quality of life ( HRQOL ) ( Euroqol-5D ) and satisfaction with pharmacy care . Adherence was continuously registered from the computerised pharmacy records . Non-adherence was defined as refilling less than 80 % of doses or having a medication-free gap of more than 1 month . Patients in the intervention group were more likely to remain adherent at 3 and 6 months follow-up but the difference was not statistically significant . Patients in the intervention group showed greater statistically significant improvement in HRQOL compared with UC patients both in the main analysis and PP analyses . No statistically significant differences were observed in clinical symptoms or satisfaction with the pharmacy service . The results of our study indicate that a brief intervention in community pharmacies does not improve  depressed patients ' adherence or clinical symptoms . This intervention helped patients to improve their HRQOL , which is an overall measure of patient status OBJECTIVE Documentation and evaluation of patient outcomes in a pilot study into the role of rural community pharmacists in the management of depression . DESIGN Parallel groups design with a control and intervention group . SETTING Thirty-two community pharmacies in rural and remote New South Wales , Australia . PARTICIPANTS One hundred and six patient participants , mean age of 46 years , predominantly female , not currently employed , recruited by participating pharmacists . INTERVENTIONS Intervention pharmacists were given video-conference training on the nature and management of depression by a psychiatrist , psychologist and general practitioner and asked to dispense medication with extra advice and support . Control pharmacists were asked to provide usual care . MAIN OUTCOME MEASURES Adherence by self-report , K10 , Drug Attitude Index . RESULTS The results indicated that adherence to medications was high in both groups ( 95 % versus 96 % ) and that both groups had improved significantly in wellbeing ( a reduction K10 score of 4 ( control ) versus 4.7 ( intervention ) ) . No significant change was found in attitude to drug treatment once baseline scores were controlled for . CONCLUSIONS Because both groups improved in wellbeing it is not possible to cl aim that the training provided to the intervention pharmacists was responsible for the success . However , the improvements gained in such a short time ( two months ) suggest that the involvement of pharmacists has had a beneficial rather than negative effect . Further research into the most appropriate ways in which to integrate the skills of pharmacists into a model of mental health care delivery in rural communities is recommended To measure the effects of a collaborative care model that emphasized the role of clinical pharmacists in providing drug therapy management and treatment follow-up to patients with depression , we conducted a r and omized controlled trial at a staff model health maintenance organization . We compared the outcomes of subjects treated in this collaborative care model ( 75 patients , intervention group ) with subjects receiving usual care ( 50 patients , control group ) . After 6 months , the intervention group demonstrated a significantly higher drug adherence rate than that of the control group ( 67 % vs 48 % , odds ratio 2.17 , 95 % confidence interval 1.04 - 4.51 , 
    Output:
    
Conclusions : The findings suggest that pharmacist interventions can enhance patient adherence to antidepressant medication in adult out patients .
However , this review failed to demonstrate a positive effect of these interventions on clinical symptoms .
Article synopsis : Pharmacists play a key role in supporting medication adherence in patients with depression given their accessibility to patients .
The findings suggest that pharmacist interventions can enhance patient adherence to antidepressant medication in adult out patients .
However , this review failed to demonstrate a positive effect of these interventions on clinical symptoms