International Journal of Clinical Pharmacy

, Volume 34, Issue 3, pp 452–459 | Cite as

Pharmaceutical care for people with depression: Belgian pharmacists’ attitudes and perceived barriers

  • Sophie LiekensEmail author
  • Tim Smits
  • Gert Laekeman
  • Veerle Foulon
Research Article


Background In the past three decades, the role of pharmacists has evolved toward working with other health professionals and the public in a patient-centered model of practice, which is called pharmaceutical care. This model has been implemented for most physical illnesses but in relation to mental health, pharmacists’ role is still evolving. Objective The objective of this study was to evaluate pharmacists’ attitudes, current practice, perceived barriers and training needs concerning pharmaceutical care for people with depression. Setting All pharmacists attending obligatory regional meetings of the Surplus Network (a Flemish community pharmacy chain) during April and May 2009. Method Written survey consisting of questions on (1) pharmacists’ attitude and current practice in depression care and pharmaceutical care for people with other illnesses; (2) potential barriers in providing pharmaceutical care for people with depression; and (3) training needs. Paired samples T tests and Wilcoxon-tests were used to analyze the data. Main outcome measure Attitude and current practice in depression care versus care for other illnesses. Results Although the results show no difference in the attitude of pharmacists toward providing care for people with depression versus other illnesses (p = 0.315), pharmacists report to provide significantly less care to people with depression compared to people with other illnesses (p < 0.05). Perceived barriers toward providing depression care were the lack of information about the person and their treatment, the fact that depression is a difficult condition, the lack of education in mental health and the lack of time and privacy in the pharmacy. These, and the reported training needs, may limit the self-efficacy of pharmacists and hence influence current practice. Conclusion In spite of pharmacists’ positive attitude toward depression care, current practice displays actionable flaws. Barriers and training needs should be addressed in order to improve pharmaceutical care for people with depression.


Belgium Depression Pharmacists’ attitudes Pharmacist-patient communication Pharmaceutical care 



The authors thank Marijn Wouters (PharmD) and Chantal Leirs (PharmD) for sampling of the data, Piet Van Maercke (PharmD) of the Pharmaceutical Chamber for providing data on the population of Flemish pharmacists, and pharmacists of the Surplus network for participating in the study. The input from Dr. Gert Scheerder and Prof. Dr. Chantal Van Audenhove in constructing the survey instrument, from Dr. Franciska Desplenter in comparing data from the study population with those of the total population of Flemish pharmacists, and from the Scientific Information Center of Escapo C.V. in running the study, was greatly appreciated.



Conflicts of interest

None declared.


  1. 1.
    Nkansah N, Mostovetsky O, Yu C, Chheng T, Beney J, Bond CM, et al. Effect of outpatient pharmacists’ non-dispensing roles on patient outcomes and prescribing patterns. Cochrane Database Syst Rev. 2010;7:CD000336.PubMedGoogle Scholar
  2. 2.
    Brook OH, Van Hout HP, Nieuwenhuysea H, De Haan M. Effects of coaching by community pharmacists on psychological symptoms of antidepressant users; a randomised controlled trial. Eur Neuropsychopharmacol. 2003;13(5):347–54.PubMedCrossRefGoogle Scholar
  3. 3.
    Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533–43.PubMedGoogle Scholar
  4. 4.
    Capoccia KL, Boudreau DM, Blough DK, Ellsworth AJ, Clark DR, Stevens NG, et al. Randomized trial of pharmacist interventions to improve depression care and outcomes in primary care. Am J Health Syst Pharm. 2004;61(4):364–72.PubMedGoogle Scholar
  5. 5.
    Bell S, McLachlan AJ, Aslani P, Whitehead P, Chen TF. Community pharmacy services to optimise the use of medications for mental illness: a systematic review. Aust New Zealand Health Policy. 2005;2:29.PubMedCrossRefGoogle Scholar
  6. 6.
    Crockett J, Taylor S, Grabham A, Stanford P. Patient outcomes following an intervention involving community pharmacists in the management of depression. Aust J Rural Health. 2006;14(6):263–9.PubMedCrossRefGoogle Scholar
  7. 7.
    George PP, Molina JA, Cheah J, Chan SC, Lim BP. The evolving role of the community pharmacist in chronic disease management—a literature review. Ann Acad Med Singapore. 2010;39(11):861–7.PubMedGoogle Scholar
  8. 8.
    Garfield S, Smith FJ, Francis SA. Roles for pharmacists in the treatment of depression in primary care. Int J Pharm Pract. 2002;10:R59.CrossRefGoogle Scholar
  9. 9.
    Al-Saffar N, Abdulkareem A, Abdulhakeem A, Salah AQ, Heba M. Depressed patients’ preferences for education about medications by pharmacists in Kuwait. Patient Educ Couns. 2008;72(1):94–101.PubMedCrossRefGoogle Scholar
  10. 10.
    World Health Organization. Improving access and use of psychotropic medicines. Geneva: Mental Health Policy and Service Guidance Package; 2005.Google Scholar
  11. 11.
    Scheerder G, De Coster I, Van Audenhove C. Pharmacists’ role in depression care: a survey of attitudes, current practices, and barriers. Psychiatr Serv. 2008;59(10):1155–60.PubMedCrossRefGoogle Scholar
  12. 12.
    Adler DA, Bungay KM, Wilson IB, Pei Y, Supran S, Peckham E, et al. The impact of a pharmacist intervention on 6-month outcomes in depressed primary care patients. Gen Hosp Psychiatry. 2004;26(3):199–209.PubMedCrossRefGoogle Scholar
  13. 13.
    Phokeo V, Sproule B, Raman-Wilms L. Community pharmacists’ attitudes toward and professional interactions with users of psychiatric medication. Psychiatr Serv. 2004;55(12):1434–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Happell B, Manias E, Roper C. Wanting to be heard: mental health consumers’ experiences of information about medication. Int J Ment Health Nurs. 2004;13(4):242–8.PubMedCrossRefGoogle Scholar
  15. 15.
    Howard PB, El-Mallakh P, Kay RM, Clark JJ. Consumer perspectives on quality of inpatient mental health services. Arch Psychiatr Nurs. 2003;17(5):205–17.PubMedCrossRefGoogle Scholar
  16. 16.
    Gray R, Rofail D, Allen J, Newey T. A survey of patient satisfaction with and subjective experiences of treatment with antipsychotic medication. J Adv Nurs. 2005;52(1):31–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Allen MH, Carpenter D, Sheets JL, Miccio S, Ross R. What do consumers say they want and need during a psychiatric emergency? J Psychiatr Pract. 2003;9(1):39–58.PubMedCrossRefGoogle Scholar
  18. 18.
    Rickles NM, Dube GL, McCarter A, Olshan JS. Relationship between attitudes toward mental illness and provision of pharmacy services. J Am Pharm Assoc. 2010;50(6):704–13.CrossRefGoogle Scholar
  19. 19.
    Bell JS, Whitehead P, Aslani P, Sacker S, Chen TF. Design and implementation of an educational partnership between community pharmacists and consumer educators in mental health care. Am J Pharm Educ. 2006;70(2):28.PubMedCrossRefGoogle Scholar
  20. 20.
    Farris KB, Schopflocher DP. Between intention and behavior: an application of community pharmacists’ assessment of pharmaceutical care. Soc Sci Med. 1999;49(1):55–66.PubMedCrossRefGoogle Scholar
  21. 21.
    Liekens S, Smits T, Laekeman G, Foulon V. Factors determining social distance toward people with depression among community pharmacists. Eur Psychiatry 2011. doi: 10.1016/j.eurpsy.2010.12.009.
  22. 22.
    Crockett J, Taylor S. Rural pharmacist perceptions of a project assessing their role in the management of depression. Aust J Rural Health. 2009;17(5):236–43.PubMedCrossRefGoogle Scholar
  23. 23.
    Cates ME, Burton AR, Woolley TW. Attitudes of pharmacists toward mental illness and providing pharmaceutical care to the mentally ill. Ann Pharmacother. 2005;39(9):1450–5.PubMedCrossRefGoogle Scholar
  24. 24.
    Aaltonen S. Laine N.P., Volmer D, Gharat MS, Muceniece R, Vitola A, et al. Barriers to medication counselling for people with mental health disorders: a six country study. Pharm Pract. 2010;8(2):122–31.Google Scholar
  25. 25.
    Scheerder G, De Coster I, Van Audenhove C. Community pharmacists’ attitude toward depression: a pilot study. Res Social Adm Pharm. 2009;5(3):242–52.PubMedCrossRefGoogle Scholar
  26. 26.
    Bell JS, Johns R, Rose G, Chen TF. A comparative study of consumer participation in mental health pharmacy education. Ann Pharmacother. 2006;40(10):1759–65.PubMedCrossRefGoogle Scholar
  27. 27.
    Badger F, Kingscote-Davies T, Nolan P. The pharmacist’s role in the medicinal management of depression. Nurs Stand. 2002;16(47):33–40.Google Scholar
  28. 28.
    Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191–215.PubMedCrossRefGoogle Scholar
  29. 29.
    Pajares F. Self-efficacy beliefs in academic settings. Rev Educ Res. 1996;66(4):543–78.Google Scholar
  30. 30.
    Einat H, George A. Positive attitude change toward psychiatry in pharmacy students following an active learning psychopharmacology course. Acad Psychiatry. 2008;32(6):515–7.PubMedCrossRefGoogle Scholar
  31. 31.
    O’Reilly CL, Bell JS, Kelly PJ, Chen TF. Impact of mental health first aid training on pharmacy students’ knowledge, attitudes and self-reported behaviour: a controlled trial. Aust N Z J Psychiatry. 2011;45(7):549–57.PubMedCrossRefGoogle Scholar
  32. 32.
    O’Reilly CL, Bell JS, Chen TF. Consumer-led mental health education for pharmacy students. Am J Pharm Educ. 2010;74(9):167.PubMedCrossRefGoogle Scholar
  33. 33.
    Lauber C, Nordt C, Falcato L, Rossler W. Factors influencing social distance toward people with mental illness. Community Ment Health J. 2004;40(3):265–74.PubMedCrossRefGoogle Scholar
  34. 34.
    Crisp A, Gelder M, Goddard E, Meltzer H. Stigmatization of people with mental illnesses: a follow-up study within the Changing Minds campaign of the Royal College of Psychiatrists. World Psychiatry. 2005;4(2):106–13.PubMedGoogle Scholar
  35. 35.
    Crisp AH, Gelder MG, Rix S, Meltzer HI, Rowlands OJ. Stigmatisation of people with mental illnesses. Br J Psychiatry. 2000;177:4–7.PubMedCrossRefGoogle Scholar
  36. 36.
    Kelly CM, Jorm AF. Stigma and mood disorders. Curr Opin Psychiatry. 2007;20(1):13–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Norman RM, Sorrentino RM, Windell D, Manchanda R. The role of perceived norms in the stigmatization of mental illness. Soc Psychiatry Psychiatr Epidemiol. 2008;43(11):851–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Sophie Liekens
    • 1
    Email author
  • Tim Smits
    • 2
    • 3
  • Gert Laekeman
    • 1
  • Veerle Foulon
    • 1
  1. 1.Research Centre for Pharmaceutical Care and Pharmaco-economicsKatholieke Universiteit LeuvenLeuvenBelgium
  2. 2.Centre for Media Culture and Communication TechnologyKatholieke Universiteit LeuvenLouvainBelgium
  3. 3.Marketing ManagementLessius University CollegeAntwerpBelgium

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