MAP-AP Study – Mental Health Assessment and Prescribing by Alberta Pharmacists
Purpose:
MAP-AP tracks and quantifies the impact of community pharmacists (practicing at the
full scope within Alberta) on the management of patients with newly diagnosed Major Depressive Disorder (MDD)
and/or Generalized Anxiety Disorder (GAD), compared to usual care
Setting:
Community Pharmacies in Alberta
Participants:
Adult patients with new diagnosis and prescribed medication for the management of
Major Depressive Disorder (MDD) and/or Generalized Anxiety Disorder (GAD)
Study Design:
Multi-centre randomized controlled trial
This study will last approximately 18 months, with each participant is enrolled for
6 months
Control Group (Standard Care)
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Receives standard care from both physician and pharmacist
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Pharmacist provides brochure from Alberta Health Services Access Mental
Health -
Completes the PHQ-9 and/or GAD-7 questionnaire at enrollment (month 0) and
prior to their 6 month in-person appointment at the end of study involvement
Intervention (Pharmacist Full Scope Interventions)
-
Same as Control group but may receive additional pharmacist involvement,
which may involve:-
Pharmacist-initiated clinical assessment
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Identification of adverse drug effects, drug interactions, or severe
deterioration (i.e. suicide attempt) -
Pharmacist-initiated drug dose adjustments, discontinuation of
medication, or prescribing adjunctive therapy -
Pharmacist-initiated collaboration with prescribing physicians
regarding medication therapy -
Medication counselling and educational support
-
Pharmacist-initiated interim follow-up interviews with patients over
the telephone/telehealth and/or in person -
Discussion with the prescribing physician to facilitate patient
referral to non-pharmacotherapy management resources (e.g. psychologist)
-
-
Completes the PHQ-9 and/or GAD-7 questionnaire at enrollment (month 0),
month 1, month 3, and prior to their 6 month in-person appointment at the end of study
involvement
Outcomes
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Primary Outcome is the mean score difference in PHQ-9 and GAD-7
scores from baseline to end of study participation between the intervention and control groups
-
Secondary Outcomes:
-
-
Difference in proportion of participants achieving clinically
significant treatment response for PHQ-9 and /or GAD-7 between groups at the end of study
period -
Difference in proportion of participants achieving remission for
PHQ-9 and /or GAD-7 between groups at the end of study period -
Difference in proportion in self-reported safety concerns during the
study period between groups
-
Rationale:
-
Stigma still presents as a major barrier to accessing care for mental health
disorders -
Bloom Program piloted in Nova Scotia revealed positive patient benefits when
community pharmacists are able to practice to their full scope for patients with mental health
conditions–highlighting greater collaborative practice and comprehensive support for patients
-
Alberta pharmacists operate with the most expansive scope of practice in
Canada, including additional prescribing authority (APA) and lab monitoring–which places community
pharmacists in a unique position to expand their involvement in the management of patients with MDD and
GAD
Research Team
Primary Investigators
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Dr. Yazid Al Hamarneh, BSc (Pharm), PhD, CDM, Department of Medicine
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yazid.alhamarneh@ualberta.ca (780) 492-9608
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Dr. Matt Chow, BSc Pharm, BSc Biology, PharmD, Alberta Health
Services-
mchow1@ualberta.ca
(587) 999-0778
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