***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: OBJECTIVE To determine ( 1 ) whether telephone follow-up using a st and ardized telemonitoring tool can influence the nature and extent to which antidepressant users provide feedback to pharmacists , ( 2 ) whether patient characteristics are associated with the extent of patient feedback , and ( 3 ) how patient feedback affects subsequent outcomes after controlling for patient characteristics . DESIGN R and omized , controlled , experimental design . SETTING Eight Wisconsin community pharmacies within a large managed care organization . PATIENTS 60 patients presenting new antidepressant prescriptions . INTERVENTIONS Three monthly telephone calls from pharmacists providing structured education and monitoring . MAIN OUTCOME MEASURES Frequency of patient feedback to pharmacists , antidepressant knowledge , beliefs , percentage of missed doses , depression symptom scores , and perceptions of progress . RESULTS Compared with usual care patients ( n=32 ) , pharmacist-guided education and monitoring ( PGEM ) patients ( n=28 ) provided significantly more feedback to pharmacists regarding different aspects of their antidepressant therapy even after controlling for patient characteristics . Regression results also showed that patient feedback was significantly associated with greater antidepressant knowledge , positive antidepressant beliefs , and perceptions of progress after 3 months . Patient feedback was unrelated to nonadherence and depressive symptoms . CONCLUSION Structured education and monitoring by pharmacists significantly improves the level of patient feedback to pharmacists , and such feedback may help pharmacists identify and address their patients ' misconceptions , concerns , and progress with antidepressant therapy Among a sample of 119 distressed high-utilizers of primary care , 45 % of patients evaluated by a psychiatrist as needing antidepressant treatment had been treated in the year before the examination . However , only 11 % of the patients needing antidepressants had received adequate dosage and duration of pharmacotherapy . In the year following the intervention , study patients whose physicians were advised regarding treatment during a psychiatric consultation  were more likely to receive  antidepressant medications  ( 52.7 % ) relative to a r and omized control group ( 36.1 % ) . However , the intervention did not significantly increase the provision of adequate antidepressant therapy  ( 37.1 % vs 27.9 % ) . Among study patients using antidepressants , patient characteristics did not differentiate patients who received adequate dosage and duration of antidepressant medications from those who did not . Analysis of data on the duration of antidepressant therapy for all health maintenance organization enrollees initiating use of antidepressants showed that only 20 % of patients who had been given prescriptions for first-generation antidepressants ( amitriptyline , imipramine , or doxepin ) filled four or more prescriptions in the following six months , compared to 34 % of patients who had prescriptions for newer antidepressants ( nortriptyline , desipramine , trazodone and fluoxetine ) . Experimental research evaluating whether these newer medications ( with more favorable side effect profiles ) improve adherence , and thereby patient outcome , is needed OBJECTIVE The most common ways of assessing adherence to oral antipsychotic medications in research and in clinical practice are self-report and physician report . This prospect i ve study examined the agreement among measures of adherence to oral antipsychotic medications among 52 out patients with schizophrenia . METHODS Participants were assessed at baseline during a visit to their outpatient clinic and followed for 12 weeks . Adherence was assessed by using subjective measures ( self-report and physician report ) and objective measures ( pill counts conducted in the home , electronic monitoring , and blood plasma concentrations ) . Electronic monitoring was used as an imperfect st and ard against which other methods were judged . RESULTS Data from pill counts and from electronic monitoring were strongly correlated ( r(k)=.61 ) . Self-report and physicians ' ratings of compliance were weakly correlated with pill count and electronic monitoring when compliance scores were examined with rank-order correlations ( r(k)=.18-.32 ) . When the sample was dichotomized into adherent and nonadherent groups on the basis of electronic monitoring or pill count ( at least 80 % adherent ) , neither physicians nor patients identified adherent behavior ( kappa < or=20 ) . Blood plasma concentrations were not correlated with any other measures of adherence ( kappa < or=20 ) . Self-report and physician report were best correlated with clinical state ( r(k)=-.27 , r(k)=-.25 ) , suggesting that patients and treating professionals may use clinical state to estimate adherence . CONCLUSIONS Patients and physicians were not able to identify adherence . The inability of physicians to accurately identify adherent individuals is likely to have important consequences for prescribing behavior , health care costs , and patient outcomes 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 The objective of this systematic review was to evaluate the impact of pharmacist delivered community-based services to optimise the use of medications for mental illness . Twenty-two controlled ( r and omised and non-r and omised ) studies of  pharmacists ' interventions in community and residential aged care setting s identified in international scientific literature were included for review . Papers were assessed for study design , service recipient , country of origin , intervention type , number of participating pharmacists , method ological quality and outcome measurement . Three studies showed that pharmacists ' medication counselling and treatment monitoring can improve adherence to antidepressant medications among those commencing treatment when calculated using an intention-to-treat analysis . Four trials demonstrated that pharmacist conducted medication review s may reduce the number of potentially inappropriate medications prescribed to those at high risk of medication misadventure . The results of this review provide some evidence that pharmacists can contribute to optimising the use of medications for mental illness in the community setting . However , more well design ed studies are needed to assess the impact of pharmacists as members of community mental health teams and as providers of comprehensive medicines information to people with schizophrenia and bipolar BACKGROUND The prevalence , long-term temporal consistency and factors influencing negative attitudes and poor treatment adherence among psychiatric patients with major depressive disorder ( MDD ) are not well known . METHODS In the Vantaa Depression Study ( VDS ) , a prospect i ve 5-year study of psychiatric patients with DSM-IV MDD , 238 ( 88.5 % ) patients ' attitudes towards and adherence to both antidepressants and psychotherapeutic treatments at baseline , 6 months , 18 months and 5 years was investigated . RESULTS Throughout the follow-up , most patients reported positive attitudes towards pharmacotherapy and psychosocial treatments  , and good adherence . While attitudes became more critical over time , adherence to psychosocial treatment improved , but remained unchanged for pharmacotherapy . Employment predicted positive attitude ( OR=1.97 , 95 % CI 1.01 - 3.83 , P=0.046 ) , and larger social network good adherence ( OR=1.11 , 95 % CI 1.00 - 1.23 , P=0.042 ) to pharmacotherapy at the last follow-up . Cluster B personality disorder symptoms predicted negative attitude ( OR=0.82 , 95 % CI 0.70 - 0.96 , P=0.012 ) and poor adherence ( OR=0.83 , 95 % CI 0.72 - 0.95 , P=0.007 ) , but cluster C symptoms positive attitude ( OR=1.30 , 95 % CI 1.09 - 1.54 , P=0.003 ) , and living alone good adherence ( OR=3.13 , 95 % CI 1.10 - 9.09 , P=0.032 ) to psychosocial treatment . LIMITATIONS Patients may exaggerate their adherence to treatments . Attrition from follow-up may occur due to undetected negative change in treatment attitude or adherence . CONCLUSIONS Among psychiatric MDD patients in long-term follow-up , treatment attitudes and adherence to  pharmaco-  and psychotherapy were and remained mostly positive . They were significantly predicted by personality features and social support . Attention to adherence of those with cluster B personality disorders , or poor social support , may be needed Introduction The efficacy of antidepressants in the treatment of depression has been convincingly demonstrated in r and omised trials . However , non-adherence to antidepressant treatment is common . Objective To evaluate , from a societal perspective , the cost effectiveness of a pharmacy-based intervention to improve adherence to antidepressant therapy in adult patients receiving treatment in primary care . Methods An economic evaluation was performed alongside a 6-month r and omised controlled trial in The Netherl and s. Patients who came to 19 pharmacies with a new prescription for a non-tricyclic antidepressant , i.e. those who had not received any prescription for an antidepressant in the past 6 months , were invited to participate . They were then r and omly allocated to education and coaching by the pharmacist or to usual care . The coaching programme consisted of three contacts with the pharmacist , with a mean duration of between 13 and 20 minutes , and a take-home video review ing important facts on depression and antidepressant treatment . The clinical outcome measures were adherence to antidepressant treatment measured using an electronic pill container ( eDEM ) and improvement in depressive symptoms measured using the Hopkins Symptom Checklist ( SCL ) . Re source use was measured by means of question naires . The uncertainty around differences in costs and cost effectiveness between the treatment groups was evaluated using bootstrapping . Results Seventy patients were r and omised to the intervention group and 81 to the usual care group ; of these , 40 in the intervention group and 48 in the control group completed all of the follow-up question naires . There were no significant differences in adherence , improvements in the SCL depression mean item score and costs over 6 months between the two treatment groups . Mean total costs ( 2002 values ) were € 3275 in the intervention group and € 2961 in the control group ( mean difference € 315 ; 95 % CI —1922 , 2416 ) . The incremental cost-effectiveness ratio associated with the pharmacist intervention was € 149 per 1 % improvement in adherence and € 2550 per point improvement in the SCL depression mean item score . Cost-effectiveness planes and acceptability curves indicated that the pharmacist intervention was not likely to be cost effective compared with usual care . Conclusion In patients starting treatment with antidepressants , there were no significant differences in adherence , severity of depression , costs and cost effectiveness between patients receiving coaching by a pharmacist and patients receiving usual care after 6 months . Considering the re sources needed to implement an intervention like this in clinical practice , based on these results , the continuation of usual care is recommended 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 
    Output:
    
The most common intervention strategy that pharmacists utilized was a combination of  patient education and drug monitoring .
This review suggests that pharmacist intervention is effective in the improvement of patient adherence to antidepressants .