Impact of pharmaceutical care interventions on antidepressants adherence and clinical outcomes in depressed patients: A systematic review

Background: Medication non-adherence, impaired health-related quality of life (HRQoL), increased depression severity, and patient dissatisfaction are common challenges among patients with depression. This systematic review aimed to evaluate the impact of pharmaceutical care interventions (PCIs) on antidepressant adherence, HRQoL, depression severity, and patient satisfaction. Methods: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across PubMed, EMBASE, Web of Science, Scopus, PsycINFO, and CINAHL for randomized controlled trials (RCTs) published between 2000 and 2024. Studies evaluating pharmacist-led pharmaceutical care interventions aimed at improving antidepressant use and related outcomes were included. Data extraction and risk of bias assessment were performed using standardized forms and the Cochrane Collaboration's Risk of Bias tool. Results: Fifteen RCTs met the inclusion criteria. Common intervention strategies included patient education, counseling, telephone follow-ups, and drug monitoring. Nine studies reported statistically significant improvements in antidepressant adherence. Of the three studies assessing HRQoL, one demonstrated significant improvement. Four of thirteen studies showed a significant reduction in depression severity, and three of five studies reported increased patient satisfaction in the intervention group compared to controls. Conclusion: Pharmaceutical care interventions, particularly patient education and counseling, contribute meaningfully in improving antidepressant adherence and related patient outcomes. However, findings across studies are inconsistent due to variability in intervention components, measurement tools, delivery methods, and outcome measures. Further research should focus on well-designed, large randomized trials with standardized, therory-based interventions.