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Major Depressive DisorderMAP-APNCT04410575

Mental Health Assessment and Prescribing by Alberta Pharmacists

A study testing Standard Pharmacist Care, Reviewed Questionnaire tool results with participant and Patient Clinical Assessment in people with Major Depressive Disorder and Generalized Anxiety Disorder, run by University of Alberta at 1 site in Canada.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a clinical trial evaluating the experimental intervention of enhanced pharmacist care by pharmacists with additional prescribing authorization (APA) in Alberta, for patients newly diagnosed with Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Standard Pharmacist Care, Reviewed Questionnaire tool results with participant and Patient Clinical Assessment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
13 participants
Where
1 siteCanada
Study dates
22 Mar 2023to 31 May 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Adults (≥ 18 years of age) newly diagnosed with MDD and/or GAD, including:
  • Patients starting on medications for the management of adults with MDD
  • Patients starting on medications for the management of GAD

Who cannot join

  • Pregnancy
  • Non-Alberta residents
  • Unwilling or unable to participate in regular follow-up visits
  • Unwilling to participate/sign consent form
  • ≥2 suicide attempts per year
  • Severe, psychotic, and catatonic depression
Show all 10Show fewer
  • History of and/or current substance abuse, intoxication, addiction or withdrawal
  • Patients diagnosed with comorbid anxiety disorders other than GAD, including: panic -disorder, agoraphobia, specific phobia, social anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder
  • Patients diagnosed with comorbid depressive disorder other than MDD, including: depressive disorder due to another medical condition (e.g. hypothyroidism, MS, OSA, -Parkinsons, stroke, TBI, Vitamin B12 insufficiency, Huntington disease, adrenal insufficiency, mononucleosis, systemic lupus erythematosus), adjustment disorder with depressed mood
  • Patients diagnosed with concurrent ADHD, bipolar disorder, schizophrenia and schizoaffective disorder

Trial locations and contacts

1 site in 1 country.

Canada1 site
  • University of Alberta

    Edmonton, Alberta, T6G 2R3

Other trials in Canada

About this study

Official title: Mental Health Assessment and Prescribing by Alberta Pharmacists (MAP-AP)

This is a clinical trial evaluating the experimental intervention of enhanced pharmacist care by pharmacists with additional prescribing authorization (APA) in Alberta, for patients newly diagnosed with Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD).

Read the detailed description

Primary objective

-To evaluate the effect of enhanced pharmacist care possible by community pharmacists with APA in comparison with usual care (standard pharmacist care and physician care) for patients with MDD and/or GAD initiated on pharmacotherapy, with focus on interventions that include:

  1. monitoring (lab ordering and interpretation, clinical monitoring of MDD and GAD) ii) patient education iii) referral facilitation (in collaboration with prescribing physician) iv) prescribing (dose adjustment and the addition of adjunctive medication)

Secondary objectives

  • To evaluate the effect of APA pharmacist interventions on: i)Clinical:
  • The rate of achieving clinical response and remission of MDD and/or GAD compared to usual care (using PHQ-9/GAD-7)
  • Change in the mean PHQ-9 and GAD-7 score
  • Cognitive and functional impairment related to MDD and/or GAD
  • The occurrence of relapse of depression and/or anxiety
  • The proportion of patients receiving appropriate and optimized depression and anxiety medication
  • Patient complaints and/or experiences of medication-related side effects during treatment for MDD and/or GAD (i.e. GI intolerance, dizziness, weight gain) ii) Process:
  • The impact of the interventions on patient satisfaction and quality of life impact (Patient survey)
  • Assure sustainability by exploring enabling (i.e. pharmacist reimbursement framework) and potential barrier forces (i.e. pharmacist training in managing patients with MDD and GAD)
Being tested
Standard Pharmacist Care, Reviewed Questionnaire tool results with participant, Patient Clinical Assessment, Psychotherapy Referral, Pharmacist initiated interim telephone follow-up with participant
Keywords
Pharmacist, Prescribing, Major Depressive Disorder, Generalized Anxiety Disorder, Mental Health, Intervention, Expanded Scope
Medical subject headings
Depressive Disorder, Major, Generalized Anxiety Disorder, Psychological Well-Being

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Standard Pharmacist CareOther

    Standard pharmacy care (as outlined in the Alberta College of Pharmacist Standards of Practice for Pharmacist and Pharmacy technicians)

  • Reviewed Questionnaire tool results with participantOther

    Pharmacist reviews results of the patient-administered PHQ-9 and/or GAD-7 questionnaire tool, at the scheduled follow-up appointment

  • Patient Clinical AssessmentOther

    Pharmacist conducts clinical assessment of the participant's major depressive disorder and/or generalized anxiety, which can include: appearance, current mood, sleeping patterns, mental health, medical history, social history, family history, relationship with others, suicidal ideation, previous suicide attempts or hospitalizations, current employment status

  • Psychotherapy ReferralOther

    Pharmacist initiates collaboration with physician to arrange referral for psychotherapy, including: psychologist, social worker, counsellor, psychiatrist

  • Pharmacist initiated interim telephone follow-up with participantOther

    Interim telephone follow-up conducted by the pharmacist since the last in-person follow-up \& a minimum of 1-2 weeks after the last in-person follow-up that involved a dose adjustment, prescribing of adjunctive medication, or discontinuation of therapy (Note: a telephone follow-up does not replace the scheduled in-person follow-up)

  • Communication update with physician after participant contactOther

    Pharmacist provides communication update (fax or electronic charting) with the participant's physician after contact with the participant

  • Medication Counselling and Educational SupportOther

    Pharmacist provides medication related counselling and educational support to participant

  • Non-medication CounsellingOther

    Pharmacist provides non-medication related counselling and educational support to participant

  • Identification of drug interactionOther

    Pharmacist identification of drug interaction related to medication for major depressive disorder and/or generalized anxiety

  • Identification of drug adverse effectOther

    Pharmacist identification of adverse effect related to medication for major depressive disorder and/or generalized anxiety

  • Identification of severe deteriorationOther

    Pharmacist identification of participant severe deterioration (i.e. suicide attempt)

  • Pharmacist-to-physician recommendation for medication adjustment, change to alternative, add-on, or deprescribingOther

    Pharmacist collaborates, discusses, and makes recommendations to physician re: treatment plan for MDD and/or GAD (as per CANMAT guidelines), which can include: medication dose adjustment, change to alternative medication, add-on, or deprescribing

  • Pharmacist initiated medication adjustment, change to alternative, add-on, or deprescribingOther

    Pharmacist initiated alteration to treatment plan for MDD and/or GAD (as per CANMAT guidelines), which can include: medication dose adjustment, change to alternative medication, add-on, or deprescribing

Study groups in NCT04410575
Study groupRoleWhat they receive
Intervention Group (Standard Pharmacist Care + Pharmacist Interventions)ExperimentalParticipants enrolled in the intervention group will receive pharmacist interventions, in addition to standard care (as outlined in the Alberta College of Pharmacist Standards of Practice for Pharmacist and Pharmacy technicians), at enrollment (month 0) and at 1, 3, and 6 month in-person follow-up appointments
Receives: Other: Standard Pharmacist Care; Other: Reviewed Questionnaire tool results with participant; Other: Patient Clinical Assessment; Other: Psychotherapy Referral; Other: Pharmacist initiated interim telephone follow-up with participant; Other: Communication update with physician after participant contact; Other: Medication Counselling and Educational Support; Other: Non-medication Counselling; Other: Identification of drug interaction; Other: Identification of drug adverse effect; Other: Identification of severe deterioration; Other: Pharmacist-to-physician recommendation for medication adjustment, change to alternative, add-on, or deprescribing; Other: Pharmacist initiated medication adjustment, change to alternative, add-on, or deprescribing
Control Group (Standard Pharmacist Care)Active comparatorPatients randomized to the usual care group will receive standard pharmacy care (as outlined in the Alberta College of Pharmacist Standards of Practice for Pharmacist and Pharmacy technicians) and physician care, at enrollment (month 0) with no specific interventions for the duration of 6 months, until the 6 month in-person follow-up appointment
Receives: Other: Standard Pharmacist Care; Other: Medication Counselling and Educational Support; Other: Non-medication Counselling; Other: Identification of drug interaction; Other: Identification of drug adverse effect; Other: Identification of severe deterioration; Other: Pharmacist-to-physician recommendation for medication adjustment, change to alternative, add-on, or deprescribing

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean score difference in Patient Health Questionnaire 9-item (PHQ-9) score

    Mean score difference in PHQ-9 score from baseline to end of study between intervention (pharmacist intervention + standard pharmacist care) group vs control (standard pharmacist care) group;

    PHQ-9 scores reflect depression severity, ranges from 0-27 (Scores: 0-4 none/minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe)

    Measured: 6 months

  2. Mean score difference in Generalized Anxiety Disorder 7-item (GAD-7) score

    Mean score difference in GAD-7 score from baseline to end of study between intervention (pharmacist intervention + standard pharmacist care) group vs control (standard pharmacist care) group;

    GAD-7 scores reflect anxiety severity; Ranges from 0-21 (Scores: 0-4 none/minimal. 5-9 mild, 10-14 moderate, 15-21 severe)

    Measured: 6 months

Secondary outcomes (5)
  1. Difference in proportion of participants achieving clinically significant treatment response in Patient Health Questionnaire 9-item (PHQ-9) score between pharmacist intervention vs. standard pharmacist care

    Clinically significant treatment response for the PHQ-9 is defined as a reduction in PHQ-9 score by at least 50% from baseline;

    PHQ-9 Scores reflect depression severity, ranges from 0-27 (Scores: 0-4 none/minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe)

    Measured: 6 months

  2. Difference in proportion of participants achieving clinically significant treatment response in Generalized Anxiety Disorder 7-item (GAD-7) score between pharmacist intervention vs. standard pharmacist care

    Clinically significant treatment response for the GAD-7 is defined as a reduction in GAD-7 score by at least 50% from baseline;

    GAD-7 scores reflect anxiety severity; Ranges from 0-21 (Scores: 0-4 none/minimal. 5-9 mild, 10-14 moderate, 15-21 severe)

    Measured: 6 months

  3. Difference in the proportion of participants with Major Depressive Disorder (MDD) to achieve Patient Health Questionnaire 9-item (PHQ-9) score <5

    Difference in the proportion of participants with MDD to achieve PHQ-9 score <5 (i.e. remission/no depression) between the pharmacist intervention and standard pharmacist care groups

    PHQ-9 scores reflect depression severity; Ranges from 0-27 (Scores: 0-4 none/minimal, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe)

    Measured: 6 months

  4. Difference in the proportion of participants with Generalized Anxiety Disorder (GAD) to achieve Generalized Anxiety Disorder 7-item (GAD-7) score <5

    Difference in the proportion of participants with GAD to achieve GAD-7 score <5 (i.e. remission/no anxiety) between the pharmacist intervention and standard pharmacist care groups;

    GAD-7 scores reflect anxiety severity; Ranges from 0-21 (Scores: 0-4 none/minimal. 5-9 mild, 10-14 moderate, 15-21 severe)

    Measured: 6 months

  5. Percentage difference in self-reported safety concerns disclosed by participant to pharmacist partner, between intervention (pharmacist intervention + standard pharmacist care) and control (standard pharmacist care) study groups, during the study period.

    The participant discloses to the pharmacist partner at any time during the duration of study, events that fit the description of a safety concern and measured via frequency of occurrence.

    Safety concerns include:

    1. Adverse Medication Effects 2) Suicide Ideation/attempt, 3) Causing withdrawal from Study

    Measured: 6 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Jun 2020
  2. Study start22 Mar 2023
  3. Primary completion31 Mar 2025
  4. Study completion31 May 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Multi-center randomized control trial evaluating the mean difference in depression and anxiety score with patients with major depressive disorder (MDD) and/or generalized anxiety disorder (GAD) by pharmacists with prescribing \& management interventions in comparison to pharmacist management per standard pharmacist care.
Masking
Double blind
Who is masked
Investigator, Outcomes assessor
Enrolment
13 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04410575
Sponsor's protocol ID
REB ID Pro00093776
Acronym
MAP-AP
Status last verified
Jul 2025
First submitted
21 May 2020
Last updated
4 Jul 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing Standard Pharmacist Care, Reviewed Questionnaire tool results with participant and Patient Clinical Assessment in people with Major Depressive Disorder and Generalized Anxiety Disorder, run by University of Alberta at 1 site in Canada.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 4 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean score difference in Patient Health Questionnaire 9-item (PHQ-9) score (time frame: 6 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Jul 2025.

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