講演情報
[P-23-01]Co-Designing a Pharmacist-Led Wellness and Wellbeing Service for Long-Term Condition Patients with Subthreshold Depression and Anxiety
*Patrick Cabasag1, Frederick Sundram2, Amy Hai Yan Chan1, Kebede Beyene3, Holly Wilson1, Jeff Harrison1 (1. School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland (New Zealand), 2. Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland (New Zealand), 3. Department of Pharmaceutical and Administrative Sciences, University of Health Sciences and Pharmacy in St Louis, St Louis, MO (United States of America))
キーワード：
depression、anxiety、chronic disease、community pharmacy services、primary care
Subthreshold depression and anxiety are prevalent conditions that cause distress and significantly impact the quality of life of individuals. If left untreated, up to 35% of individuals may develop clinically diagnosed mental health conditions. Subthreshold conditions are often linked with long-term conditions (LTCs). Community pharmacists, who already have an established rapport and regular contact with LTC patients, are in a unique position to address these conditions.
The aim of this research is to design a pharmacist-led service for LTC patients experiencing subthreshold depression and anxiety.
A co-design approach was taken to service design, involving community pharmacists, key stakeholders – including policymakers and health professionals – and consumers. The barriers and facilitators to implementation were identified through qualitative interviews and mapped using the Consolidated Framework for Implementation Research (CFIR) domains. The service was iteratively refined through feedback from the advisory group and interview participants.
The service model uses the Patient Health Questionnaire - 9 (PHQ-9) and Generalised Anxiety Disorder 7-item scale (GAD-7) to screen participants for subthreshold depression and anxiety. Depending on how participants screen in these questionnaires, participants will be managed appropriately. The main intervention component is Focused Acceptance and Commitment Therapy (FACT), with self-help cognitive behavioural therapy (CBT) resources and referral as the other management options.
There is potential for community pharmacies to play a key role in addressing subthreshold depression and anxiety in LTC patients. Future research would need to investigate the feasibility of the proposed service. If shown to be feasible, subsequent studies should evaluate the effectiveness and cost-effectiveness of the service.
The aim of this research is to design a pharmacist-led service for LTC patients experiencing subthreshold depression and anxiety.
A co-design approach was taken to service design, involving community pharmacists, key stakeholders – including policymakers and health professionals – and consumers. The barriers and facilitators to implementation were identified through qualitative interviews and mapped using the Consolidated Framework for Implementation Research (CFIR) domains. The service was iteratively refined through feedback from the advisory group and interview participants.
The service model uses the Patient Health Questionnaire - 9 (PHQ-9) and Generalised Anxiety Disorder 7-item scale (GAD-7) to screen participants for subthreshold depression and anxiety. Depending on how participants screen in these questionnaires, participants will be managed appropriately. The main intervention component is Focused Acceptance and Commitment Therapy (FACT), with self-help cognitive behavioural therapy (CBT) resources and referral as the other management options.
There is potential for community pharmacies to play a key role in addressing subthreshold depression and anxiety in LTC patients. Future research would need to investigate the feasibility of the proposed service. If shown to be feasible, subsequent studies should evaluate the effectiveness and cost-effectiveness of the service.