Discontinuation of Antidepressant Medication Among Latinos in the USA

Abstract

Despite recent growth in the variety of antidepressant medications available, many patients discontinue medication prematurely, for reasons such as nonresponse, side effects, stigma and miscommunication. Some analysts have suggested that Latinos may have higher antidepressant discontinuation rates than other US residents. This paper examines Latino antidepressant discontinuation, using data from a national probability survey of Latinos in the US. In this sample, 8% of Latinos had taken an antidepressant in the preceding 12 months. Among those users, 33.3% had discontinued taking antidepressants at the time of interview, and 18.9% had done so without prior input from their physician. Even controlling for clinical and other variables, patients who reported good or excellent English proficiency were less likely to stop at all. Patients were also less likely to stop if they were older, married, had public or private insurance, or had made eight or more visits to a nonmedical therapist.

Psychotropic Medication Nonadherence Among United States Latinos: A Comprehensive Literature Review

“…Study objectives varied, with some focusing specifically on adherence (1, 6, 41, 44–47, 49, 51–60) while others measured adherence as part of studies addressing different questions. Geographically, eight were based in California (6, 42, 43, 47, 48, 50, 54, 55), two in Texas (41, 51), one in New Mexico (52), one in New York (49), one in Connecticut (56), one in Ohio (40), and four were from Veteran’s Administration National Registries (46, 58–60), and three were national studies (1, 45, 57). …”

“…Twelve reports (N= 12) investigated nonadherence to antipsychotics (1, 6, 41–43, 46, 49–51, 54, 58, 59), five antidepressants (45, 47, 52, 55, 57), two mood stabilizers (48, 60), and two a combination of these medications (40, 56). Ten studies focused on schizophrenia or schizoaffective disorder (1, 6, 41–43, 49–51, 59), five on depression (45, 47, 52, 55, 57), three on bipolar disorder (48, 58, 60), and three a combination of those diagnoses (40, 54, 56).…”

“…Ten studies focused on schizophrenia or schizoaffective disorder (1, 6, 41–43, 49–51, 59), five on depression (45, 47, 52, 55, 57), three on bipolar disorder (48, 58, 60), and three a combination of those diagnoses (40, 54, 56). …”

“…Studies used a range of adherence measures including: patient report (50, 55); chart review or physician report (41); a combination of patient and family report and chart review (43, 49); medication discontinuation (by patient report) (45, 47, 57); pill counts of returned pills (46); Medication Event Monitoring System (MEMS) pill bottle caps (56); calculations from pharmacy records (including CMGR, MPR, CPR) (1, 6, 48, 51, 52, 58–60); urine testing for metabolites (54); and not stated (40, 42). Nineteen studies reported the time period used to examine adherence, which ranged from one week to 48 months (mean 10.2months±10.3).…”

“…Three (41, 43, 45) of the four studies including only Latinos (Table 1) reported nonadherence rates, which ranged from 33.0 to 55.0% (mean 44.0±11.0). The fourth explored risk factors for nonadherence in Latinos but did not detail rates and is discussed later (42).…”