Constraints and perspectives of pharmacists counseling patients with depression at hospital discharge.

objective of the studyThis study aims to explore experiences, barriers and enabling factors during an antidepressant counseling study as well as to explore future initiatives.

setting11 Flemish psychiatric hospitals.

methodFocus group discussions were organized. Pharmacists who could not be present at a focus group discussion answered the questions of the interview guide on paper. The focus group discussions were tape recorded, verbatim transcribed and analyzed using NVivo7-software applying a framework approach.

main outcome measureEvaluation of barriers, enabling factors, negative and positive experiences during the study. Suggestions for future initiatives.

resultsFor experiences, barriers and enabling factors, five categories were identified: individual patient contacts, interdisciplinary contacts, hospital management, study performance and study support. There existed differences in culture between hospitals on how they appreciated the role of the clinical pharmacist. A major difference between hospitals was the interdisciplinary relations. Negative experiences and barriers were: the absence of openness for a role for the pharmacist in the team, difficult interdisciplinary communication, the uncertainty about the time of discharge, the need of patients to tell their story and the timing of the intervention. Positive experiences and enabling factors included the individual focus of the intervention, the position of the pharmacist as a reliable health care professional, the pharmacist as the key person in this study, the integration of the pharmacist in the team, the gained knowledge and skills of the pharmacist and the professional study support. Future initiatives depend upon human and other resources. There is a demand for more information by the patient. A more structured way of working is necessary. The provision of medication information can be performed at different points in time using different formats.

conclusionParticipation in a clinical pharmacy study was well appreciated by the pharmacists. Future initiatives were welcomed if they remain feasible within actual job responsibilities.