An Evaluation of the Impact of Pharmacist Comprehensive Medication Management With Pharmacogenomic Results to Improve Depression Outcomes in Community Pharmacies.

Change in the Extent of Adherence and Reasons for Nonadherence Survey (Voils et al.) score

The Extent of Adherence and Reasons for Nonadherence Survey (Voils et al.) is a validated self-report measure assessing medication adherence over the past 7 days. It is scored on a 1-5 Likert scale and averaged to produce a continuous score, with higher scores indicating better adherence. The Reasons for Nonadherence scale assesses specific barriers to taking medication as prescribed, with items rated on a 1-5 scale and assessed individually to identify the degree to which each barrier contributed to missed doses.

Time frame: Baseline, 6 Months

Change in Generalized Anxiety Disorder Assessment (GAD-7) score

The Generalized Anxiety Disorder Assessment (GAD-7) is a 7-item self-report measure assessing anxiety symptoms over the past two weeks, with items scored 0-3 for a total score of 0-21; higher scores indicate more severe anxiety, categorized as minimal (0-4), mild (5-9), moderate (10-14), and severe (15-21).

Time frame: Baseline, 6 Weeks, 12 Weeks, 6 Months

Proportion of pharmacist recommendations were accepted

Proportion of pharmacist recommendations to address medication-related problems that were accepted by providers as assessed by EHR and fill data review.

Time frame: 6 months

Change in frequency of CPIC/FDA guideline concordant prescribing

Change in frequency of concordance of participant medication regimen with pharmacogenomics prescribing recommendations according to the Clinical Pharmacogenomics Implementation Consortium (CPIC) and U.S. Food \& Drug Administration (FDA) guidelines using electronic health record data.

Time frame: Baseline, 6 Months

Number of adverse events as assessed using the Frequency, Intensity, and Burden of Side Effect rating scale (FIBSER).

The Frequency, Intensity, and Burden of Side Effect Rating Scale (FIBSER) is a 3-item self-report measure assessing medication side effects. It evaluates the frequency, intensity, and functional burden of side effects over the past week, with each item rated on a 0-6 scale; higher scores indicate more frequent, severe, or burdensome side effects. Clinically, a total score of 0-2 typically requires no change in treatment, 3-4 side effects may warrant targeted management, and 5-6 indicates that treatment modification should be considered to improve tolerability and adherence.

Time frame: Baseline, 6 Weeks, 12 Weeks, 6 Months

Frequency of Actionable Genotypes

Frequency of actionable genotypes (in the entire study population) based on report of a genotype-predicted phenotype. Actionable genotypes are defined as those with recommendations for a change in prescribing by a CPIC (Clinical Pharmacogenetics Implementation Consortium) guidelines or FDA recommendations.

Time frame: 6 months

Number of participant medications with PGx guidance based on PGx testing results.

This measure counts the number of a participant's medications for which pharmacogenomic (PGx) guidance is available based on PGx testing results. Medications with PGx guidance may have dosing recommendations, alternative drug options, or monitoring considerations informed by the participant's genetic profile.

Time frame: 6 months

Change in healthcare utilization

Change in participant ER visits, hospitalizations, urgent care visits, specialist appointments, primary care appointments, and unplanned care using UPMC EHR data.

Time frame: From Baseline to 6 Months