Patient adherence in the treatment of depression

Pampallona, Sandro; Bollini, Paola; Tibaldi, Giuseppe; Kupelnick, Bruce; Munizza, Carmine

doi:10.1192/bjp.180.2.104

Cited by 247 publications

(191 citation statements)

References 38 publications

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“…Based upon prior studies finding racial differences in various components of depression care, we hypothesized that older African-American subjects would have significantly lower rates of four-month adherence than older white subjects. Consistent with prior work documented in the elderly [19], for the study population as a whole, we found that overall adherence was lower than optimal (approximately 60%). Older African-American adults had significantly lower rates of antidepressant adherence than white older adults in models adjusting for demographic characteristics and symptom variables, but not in models that also included functional status variables.…”

Section: Discussionsupporting

confidence: 90%

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Racial Differences in Adherence to Antidepressant Treatment in Later Life

Kales

Nease

Sirey

et al. 2013

The American Journal of Geriatric Psychiatry

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Objective Although antidepressants are an effective treatment for later-life depression, older patients often choose not to initiate or to discontinue medication treatment prematurely. While racial differences in depression treatment preferences have been reported, little is known about racial differences in antidepressant medication adherence among older patients. Design Prospective, observational study comparing antidepressant adherence for older African-American and white primary care patients. Participants One hundred and eighty-eight subjects aged 60 and older, diagnosed with clinically significant depression with a new recommendation for antidepressant treatment by their primary care physician. Measurement Study participants were assessed at study entry and at four-month follow-up (encompassing the acute treatment phase). Depression medication adherence was based on a well-validated self-report measure. Results At four-month follow-up, 61.2% of subjects reported that they were adherent to their antidepressant medication. In unadjusted and two of the three adjusted analyses, African-American subjects (n=82) had significantly lower rates of four-month antidepressant adherence than white subjects (n=106). African-American females had the lowest adherence rates (44.4%) followed by African-American males (56.8%), white males (65.3%) and white females (73.7%). In logistic regression models controlling for demographic, illness, and functional status variables, significant differences persisted between African-American women and white women in reported four-month antidepressant adherence (OR 3.58, 95% CI 1.27-10.07, Wald Chi-square =2.42, df=1, p<0.02). Conclusions The results demonstrate racial and gender differences in antidepressant adherence in older adults. Depression treatment interventions for the older adults should take into account the potential impact of race and gender on adherence to prescribed medications.

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Section: Discussionsupporting

confidence: 90%

“…Non-adherence is common, with estimates ranging from 40% to 75% [19]. Thus, even with successful screening and diagnosis of late-life depression in health care settings, a second-generation problem of a “treatment gap”, has emerged.…”

Section: Introductionmentioning

confidence: 99%

Racial Differences in Adherence to Antidepressant Treatment in Later Life

Kales

Nease

Sirey

et al. 2013

The American Journal of Geriatric Psychiatry

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“…Numerous studies have documented high rates of discontinuation of antidepressants, 3,[8][9][10][11][12][13][14][15] with one review reporting that between 45 and 60% of patients stop taking prescribed antidepressants within 3 months of beginning treatment. 14 A minimum of six to nine months of pharmacotherapy is recommended for depression treatment after symptoms resolve, 16 17 but given the chronic and recurring nature of most other indications for antidepressants (e.g.…”

Section: Introductionmentioning

confidence: 99%

Discontinuation of Antidepressant Medication Among Latinos in the USA

Hodgkin

Volpe-Vartanian

Alegrı́a

2007

J Behav Health Serv Res

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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.

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“…[15][16][17][18] Most of those who do access depression treatment receive it in primary care settings, 9,14,15,19 where antidepressants are the most common form of treatment. However, patient adherence to antidepressants is poor (40%-75%), 20 and many individuals do not consider antidepressants acceptable treatments 21 or prefer to be treated without medication. [22][23][24][25][26] Individuals who are dissatisfied with the availability of conventional treatment, report difficulty getting treatment, or are unable to get treatment are more likely to use CHAs.…”

mentioning

confidence: 99%

Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review

Burnett-Zeigler

Schuette

Victorson

et al. 2016

The Journal of Alternative and Complementary Medicine

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Mind-body approaches are commonly used to treat a variety of chronic health conditions, including depression and anxiety. A substantial proportion of individuals with depression and anxiety disorders do not receive conventional treatment; disadvantaged individuals are especially unlikely to receive treatment. Mind-body approaches offer a potentially more accessible and acceptable alternative to conventional mental health treatment for disadvantaged individuals, who may not otherwise receive mental health treatment. This review examines evidence for the efficacy of mind-body interventions for mental health symptoms among disadvantaged populations. While rates of utilization were relatively lower for racial/ethnic minorities, evidence suggests that significant proportions of racial/ethnic minorities are using complementary health approaches as health treatments, especially prayer/healers and natural or herbal remedies. This review of studies on the efficacy of mind-body interventions among disadvantaged populations found evidence for the efficacy of mind-body approaches for several mental and physical health symptoms, functioning, self-care, and overall quality of life.

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Patient adherence in the treatment of depression

Abstract: The studies did not give consistent indications of which interventions may be effective. Carefully designed clinical trials are needed to clarify the effect of single and combined interventions.

Cited by 247 publications

References 38 publications

Racial Differences in Adherence to Antidepressant Treatment in Later Life

Racial Differences in Adherence to Antidepressant Treatment in Later Life

Discontinuation of Antidepressant Medication Among Latinos in the USA

Mind–Body Approaches to Treating Mental Health Symptoms Among Disadvantaged Populations: A Comprehensive Review

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