Telling results from mental healthcare study

Recent research confirms pharmacists’ potential to improve outcomes in mental health when they provide enhanced services—and ironically helps illustrate the precarity of pharmacists’ own capacity to do more.

The Canadian Foundation for Pharmacy announced funding for the Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP) study in 2019. The objective was to assess the clinical effectiveness of enhanced pharmacist care for patients newly initiated on pharmacotherapy for major depressive disorder (MDD) or generalized anxiety disorder (GAD).

Eight pharmacies representing multiple pharmacy formats came on board, and participating pharmacists—all of whom had additional prescribing authority—received additional education on MDD, GAD, switching medications, adverse effects, and interpreting the PHQ-9 and GAD-7 scoring tools (the two validated patient questionnaires for MDD and anxiety, respectively). The goal was to enroll 94 patients (half in the enhanced-care group and half in the standard-care control group).

Then the COVID-19 pandemic swept the globe. Not unexpectedly, the study’s concluding report noted “significant recruitment challenges” due to staff shortages and pharmacist burnout.

Recruitment was suspended until March 2023 and several pharmacies dropped out of the study entirely. Those remaining reported continued challenges in enrolling and following up with participants. The main barriers were time constraints, workflow integration, inadequate remuneration and inconsistent staff engagement. Pharmacists also reported hesitancy and discomfort among patients, some of whom dropped out or had to be contacted multiple times for follow-ups.

In the end, by March 2025, 13 participants in two pharmacies completed the six-month study period. While the small sample size means the findings are descriptive rather than quantitative, all participants in the intervention group recorded strong improvements in their mental health based on PHQ-9 or GAD-7 scores.

Pharmacists also reported professional satisfaction, despite the challenges. “The patients that showed benefit by intervention… showed a quality-of-life improvement. It was evident by the smiles and thank yous,” wrote one.

Matt Chow

“If I were to summarize it in two words, I’d say the study revealed a lot of optimistic potential,” says Dr. Matt Chow, primary investigator, who worked with Yazid Al Hamarneh, Assistant Professor at the University of Alberta and Associate Director of the University’s Epicore Centre.

The study also helped Chow realize his own potential as a pharmacist specializing in mental health care. When doing his post-graduate PharmD in 2018 and 2019, Chow’s rotations in psychiatric practice ignited his interest in mental health care, which led to his involvement in the study. “These experiences inspired my curiosity to explore the potential longitudinal benefits to patients in the community pharmacy setting,” says Chow.

In June this year, after more than 13 years working as a clinical pharmacist for Alberta Health Services, Chow became the owner and operator  of The Medicine Shoppe Elbow (#441) pharmacy in southwest Calgary. So far, he is thrilled with the progress he’s making in mental health care in his own community practice. “Patients want to be heard, seen, and understood. They deserve exceptional, individualized care—my non-negotiable standard,” says Chow.

One psychiatrist recently called to say how impressed they were with his initiative to reach out and follow through with high-level clinical care planning and collaboration. “I have the patient’s psychiatrist, GP, counselor and sports therapist all looped together in ongoing communication with the patient. We’re slowly helping him get his life back,” says Chow.

While Chow would be the first to agree with the study’s participating pharmacists that limited public remuneration for pharmacist-led services is an ongoing challenge, he leverages available funding mechanisms—such as Alberta’s Comprehensive Annual Care Plan—to help sustain the delivery of patient-centred services in his pharmacy.

And until there are separate billing codes for these types of services as there are for physicians, he hopes that overall growth in the business will also be enough to sustain his commitment to longitudinal care. “In a profession built on trust, my goal is to create meaningful relationships that endure, because when patients feel genuinely cared for, they not only return—they become lifelong advocates,” says Chow.