Antidepressant Prescribing: Insights from Family Medicine Residents with Embedded Clinical Pharmacists

Authors' Affiliations

McKenzie Highsmith, Department of Pharmacy Practice, Bill Gatton College of Pharmacy, East Tennessee State University Madison Sutton, PharmD Candidate 2024, Bill Gatton College of Pharmacy, East Tennessee State University

Location

D.P. Culp Center Ballroom

Start Date

4-5-2024 9:00 AM

End Date

4-5-2024 11:30 AM

Poster Number

43

Name of Project's Faculty Sponsor

Brandi Dahl

Faculty Sponsor's Department

Pharmacy Practice

Classification of First Author

Medical Resident or Clinical Fellow

Competition Type

Competitive

Type

Poster Presentation

Presentation Category

Health

Abstract or Artist's Statement

Antidepressant medications are commonly used in developed countries and frequently continued for many years. These medications often carry risks related to drug interactions and side effects, which can increase as patients age. A gap in evidence exists focusing on physician practices related to setting expectations and educating patients on long-term use when initiating therapy. This cross-sectional study aims to gain insight into the shared decision-making conversations and counseling related to duration, therapy selection, and long-term risks that occur when antidepressant medications are first prescribed. Resident physicians at three university-affiliated family medicine clinics were asked to participate in a voluntary, online cross-sectional survey. Questions were created to assess prescribing practices and patient education efforts when initiating common antidepressant medications. Likert scale rankings were utilized for ranking position statements and common patient counseling points. University IRB approval was granted, and informed consent was collected. Participants were asked to provide their current year in post-graduate training, but no other identifying information was collected. Descriptive statistics were used for global survey responses. One-way ANOVA was used to compare ordinal data across three groups (post-graduate year one, two, and three). Prior Doctor of Pharmacy (PharmD) education related to prescribing antidepressant pharmacotherapy was evaluated via t-test analysis as a potential confounding factor due to increasing exposure to embedded clinical ambulatory care pharmacists over the three-year residency training period. The survey was completed by 18 family medicine residents. Through this survey, several opportunities for additional education related to antidepressant prescribing were revealed. Out of the 35 items that were surveyed, ANOVA analysis revealed statistically significant differences across the class ranks for 4 of the 35 items. Through t-test analysis, 5 of the 35 items revealed a statistically significant difference between those who had received prior PharmD education regarding antidepressant medications. Many survey items showed trends across each residency year class revealing opportunities for additional training. As expected, the data suggest increasing confidence as residency training nears its end. The small sample limits the external validity of this survey, and each clinic already has a pharmacist embedded in the clinic as faculty. More studies with larger sample sizes and a variety of clinics are needed to gain better understanding of antidepressant prescribing practices of family medicine residents. The data collected will be used to provide educational programming to the family medicine residents in the coming months.

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Apr 5th, 9:00 AM Apr 5th, 11:30 AM

Antidepressant Prescribing: Insights from Family Medicine Residents with Embedded Clinical Pharmacists

D.P. Culp Center Ballroom

Antidepressant medications are commonly used in developed countries and frequently continued for many years. These medications often carry risks related to drug interactions and side effects, which can increase as patients age. A gap in evidence exists focusing on physician practices related to setting expectations and educating patients on long-term use when initiating therapy. This cross-sectional study aims to gain insight into the shared decision-making conversations and counseling related to duration, therapy selection, and long-term risks that occur when antidepressant medications are first prescribed. Resident physicians at three university-affiliated family medicine clinics were asked to participate in a voluntary, online cross-sectional survey. Questions were created to assess prescribing practices and patient education efforts when initiating common antidepressant medications. Likert scale rankings were utilized for ranking position statements and common patient counseling points. University IRB approval was granted, and informed consent was collected. Participants were asked to provide their current year in post-graduate training, but no other identifying information was collected. Descriptive statistics were used for global survey responses. One-way ANOVA was used to compare ordinal data across three groups (post-graduate year one, two, and three). Prior Doctor of Pharmacy (PharmD) education related to prescribing antidepressant pharmacotherapy was evaluated via t-test analysis as a potential confounding factor due to increasing exposure to embedded clinical ambulatory care pharmacists over the three-year residency training period. The survey was completed by 18 family medicine residents. Through this survey, several opportunities for additional education related to antidepressant prescribing were revealed. Out of the 35 items that were surveyed, ANOVA analysis revealed statistically significant differences across the class ranks for 4 of the 35 items. Through t-test analysis, 5 of the 35 items revealed a statistically significant difference between those who had received prior PharmD education regarding antidepressant medications. Many survey items showed trends across each residency year class revealing opportunities for additional training. As expected, the data suggest increasing confidence as residency training nears its end. The small sample limits the external validity of this survey, and each clinic already has a pharmacist embedded in the clinic as faculty. More studies with larger sample sizes and a variety of clinics are needed to gain better understanding of antidepressant prescribing practices of family medicine residents. The data collected will be used to provide educational programming to the family medicine residents in the coming months.