The Role of Qatar Community Pharmacists in Depression Care: A Survey of Attitudes, Practices and Perceived Barriers

Abstract

Background: Negative attitudes and stigma are considered to be major barriers to healthcare and quality of life around the world for patients with depression. Community pharmacists are one of the most accessible healthcare providers. They can enhance patients’ adherence to antidepressant regimens through counselling on depression and antidepressant medications, as well as the provision of adequate follow up and medication management. Aim: Our study aims to describe the current practices, attitudes and perceived barriers of Qatar community pharmacists in relation to the provision of depression care. Methods: This is a cross-sectional online survey targeting all practicing community pharmacists in Qatar using an adapted survey instrument. Responses were measured on a 5-point-Likert scale. Study outcomes were scores of attitudes to depression, scores of self-reported depression care practices and the number of perceived barriers. These scores were produced by summing the individual scores of a set of survey items under the domain used to assess each outcome. Descriptive analyses of pharmacists’ responses were done using means and standard deviations for continuous variables, and frequency tables for categorical variables. Bivariate and multivariate regression analyses were also employed to investigate how pharmacists’ characteristics and attitude affected their practice. Statistical analysis was conducted using STATA version 15.1 and assigned a p-value of 0.05 for statistical significance. Results: The survey had a response rate of 39%. Pharmacists’ attitudes to depression were moderately positive. Out of a possible score of 5, the mean score of attitudes was 3.41, with a standard deviation of 0.94. However, the extent of pharmacists’ involvement in depression care was very low. Out of a possible score of 5, pharmacists’ practices had a mean score of 2.64 and a standard deviation of 0.26. The top three reported barriers were the lack of access to patients' medical records (83.21%), lack of patients’ insight on major depression and the importance of treatment (81.85%) and the lack of needed knowledge and training on mental health (79.63%), respectively. Female pharmacists were significantly less involved in depression care compared to male pharmacists (p= 0.006). Depression practice score increased with an increasing score of attitudes (p =0.001), and decreased with the number of years since the last pharmacy degree graduation (p=0.02).The presence of a private area for counselling patients was associated with higher scores of practice (p=0.03). Pharmacists’ practice scores varied across types of pharmacy setting, where pharmacists who worked in pharmacies located in shopping malls and supermarkets showed the highest scores of practice compared to community pharmacies of private hospitals (p=0.05). Conclusion: Pharmacists’ moderately positive attitudes towards depression and its care were not reflected in their current practices. A set of perceived barriers against the provision of depression care were also identified in this study. Results from this study could serve as an evidence base for future longitudinal studies in Qatar, implying a need for the development of local depression care and training programs for pharmacists to improve their knowledge and improve their attitude towards depression care.