Failure to adhere to prescribed medications can result in numerous adverse clinical outcomes, such as elevated chances of relapse and disease recurrence. Through the delivery of personalized, face-to-face pharmaceutical care guidance, pharmacists have a vital role in fostering better medication adherence. In contemporary society, smartphones are among the most prevalent modes of communication. Therefore, incorporating a dedicated smartphone application for managing depression represents a promising approach to optimizing patient results. To determine if targeted counseling for depression paired with a specialized smartphone application can boost medication adherence in individuals recently diagnosed with major depressive disorder (MDD). This was a prospective, randomized pilot trial involving patients with newly identified major depressive disorder. Participants were allocated randomly to the intervention or standard care arms in a 1:1 ratio. The intervention arm received face-to-face pharmaceutical care guidance combined with training on a depression-focused smartphone application, while the standard care arm was provided with conventional pharmaceutical guidance and a basic chatbot. Medication adherence, the main endpoint, was assessed via the Medication Adherence Rating Scale (MARS) and pill count percentage (PC) during the one-month follow-up visit. As a secondary endpoint, the Patient Health Questionnaire-9 (PHQ-9) was employed to evaluate changes in depressive symptomatology. A total of 36 individuals finished the trial (18 in each arm). The mean participant age was 29.81 years, and 65.38% were women. Both arms exhibited comparable baseline features, including initial PHQ-9 values. The intervention arm recorded a mean MARS score of 7.0 (IQR=5), surpassing the standard care arm's mean of 4.5 (IQR=7; p-value=0.04). Pill count percentage was higher in the intervention arm at 81.75 (IQR=33.33) compared to 69.95 (IQR=78.57) in the standard care arm (p-value=0.10). The average change in PHQ-9 scores across visits showed a difference of -1.44 [-2.61 to -0.28] favoring the intervention arm (p-value=0.02). The findings indicate that individuals newly diagnosed with major depression who were given specialized pharmaceutical guidance for depression alongside a smartphone application exhibited enhanced medication adherence. Moreover, there was a notable amelioration in general depressive symptomatology.
