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Patient adherence in the treatment of depression

  • S. Pampallona (a1), P. Bollini (a1), G. Tibaldi (a2), B. Kupelnick (a2) and C. Munizza (a2)...
Abstract
Background

Non-adherence with antidepressant treatment is very common. Increasing adherence to pharmacological treatment may affect response rate.

Aims

To review and summarise quantitative evidence on factors associated with adherence and of adherence-enhancing interventions.

Method

A systematic review of computerised databases was carried out to identify quantitative studies of adherence in depression. Papers retained addressed unipolar depression and considered adherence as the primary end-point.

Results

Of studies published between 1973 and 1999, 32 met the review criteria: epidemiological descriptive studies (n=14): non-random comparisons of control and intervention groups (n=3); randomised interventions (n=14); and meta-analysis (n=1). Patient education and medication clinics were the interventions most commonly tested, combined with a variety of other interventions.

Conclusions

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.

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Copyright
Corresponding author
Dr Carmine Munizza, Centro Studi e Ricerche in Psichiatria, Piazza del Donatore di Sangue 3, 10154 Torino, Italy
Footnotes
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Declaration of interest

The study was partially supported by Centro Studi e Ricerche in Psichiatria, Turin; Istituto Superiore di Sanità, Rome; and Ravizza Pharmaceuticals, Milan.

Footnotes
References
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Roter, D. L., Hall, J. A., Merisca, R., et al (1998) Effectiveness of interventions to improve patient compliance. Medical Core, 36, 11381161.
Blouin, A., Perez, E. & Minoletti, A. (1985) Compliance to referrals from the psychiatric emergency room. Canadian Journal of Psychiatry, 30, 103106.
Craig, T. G., Huffine, C. L. & Brooks, M. (1974) Completion of referral to psychiatric services by inner city residents. Archives of General Psychiatry, 31, 353357.
Croghan, T. W., Lair, T. J., Engelhart, L., et al (1997) Effect of antidepressant therapy on health care utilization and costs in primary care. Psychiatric Services, 48, 14201426.
Engstrom, F. W. (1991) Clinical correlates of antidepressant compliance. In Patient Compliance in Medical Practice and Clinical Trials (eds Cramer, J. A. & Spilker, B.), pp. 187194. New York: Raven Press.
Hall, D., Wiles, D. H. & McCreadie, R. G. (1990) Compliance with antidepressant medication (letter). British Journal of Psychiatry, 157, 453454.
Johnson, D. A. W. (1981) Depression: treatment compliance in general practice. Acta Psychiatrica Scandinavica, 290 (suppl. 63), 447453.
Last, C. G., Thase, M. E., Hersen, M., et al (1985) Patterns of attrition for psychosocial and pharmacologic treatments of depression. Journal of Clinical Psychiatry, 46, 361366.
Maddox, J. C., Levi, M. & Thompson, C. (1994) The compliance with antidepressants in general practice. Journal of Psychopharmacology,8, 4853.
Matas, M., Staley, D. & Griffin, W. (1992) A profile of the non compliant patient: a thirty-month review of outpatient psychiatry referrals. General Hospital Psychiatry, 14, 124130.
Melfi, C. A., Chawla, A. J. Croghan, T. W., et al (1998) The effects of adherence to antidepressant treatment guidelines on relapse and recurrence of depression. Archives of General Psychiatry, 55, 11281132.
Robinson, P., Bush, T., Von Korff, M., et al (1995) Primary care physician use of cognitive behavioral techniques with depressed patients. Journal of Family Practice, 40, 352357.
Simon, G. E., Von Korff, M., Wagner, E. H., et al (1993) Patterns of antidepressant use in community practice. General Hospital Psychiatry, 15, 399408.
Tedlow, J. R., Fava, M., Uebelacker, L. A., et al (1996) Are study dropouts different from completers? Biological Psychiatry, 40, 668670.
Voris, J. C., Morin, C. & Kiel, J. S. (1983) Monitoring outpatients' plasma antidepressant-drug concentrations as a measure of compliance. American Journal of Hospital Pharmacy, 40, 119120.
Daley, D. C., Salloum, I. M., Zuckoff, A., et al (1998) Increasing treatment adherence among outpatients with depression and cocaine dependence: results of a pilot study. American Journal of Psychiatry, 155, 16111613.
Myers, E. D. & Calvert, E. J. (1976) The effect of forewarning on the occurrence of side-effects and discontinuance of medication in patients on dothiepin. International Journal of Medical Research, 4, 237240.
Seltzer, A., Roncari, I. & Garfinkel, P. (1980) Effect of patient education on medication compliance. Canadian Journal of Psychiatry, 25, 638645.
Altamura, A. C. & Mauri, M. (1985) Plasma concentrations, information and therapy adherence during long-term treatment with antidepressants. British Journal of Clinical Pharmacology, 20, 714716.
Demyttenaere, K., Van Ganse, E., Gregoire, J., et al (1998) Compliance in depressed patients treated with fluoxetine or amitriptyline. International Clinical Psychopharmacology, 13, 1117.
Katon, W., Von Korff, M., Lin, E., et al (1995) Collaborative management to achieve treatment guidelines. Impact on depression in primary care. Journal of the American Medical Association, 273, 10261031.
Katon, W., Robinson, P., Von Korff, M., et al (1996) A multifaceted intervention to improve treatment of depression in primary care. Archives of General Psychiatry, 53, 924932.
Katon, W., Von Korff, M., Lin, E., et al (1999) Stepped collaborative care for primary care patients with persistent symptoms of depression. Archives of General Psychiatry, 56, 11091115.
Kemp, R., Hayward, P., Applewhaite, G., et al (1996) Compliance therapy in psychotic patients: randomised controlled trial. British Medical Journal, 312, 345349.
Myers, E. D. & Branthwaite, A. (1992) Out-patient compliance with antidepressant medication. British Journal of Psychiatry, 160, 8386.
Myers, E. D. & Calvert, E. J. (1973) The effect of forewarning on the occurrence of side-effects and discontinuance of medication in patients on amitriptyline. British Journal of Psychiatry, 122, 461464.
Myers, E. D. & Calvert, E. J. (1984) Information, compliance and side-effects: a study of patients on antidepressant medication. British Journal of Clinical Pharmacology, 17, 2125.
Peveler, R., George, C., Kinmonth, A.-L., et al (1999) Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial. British Medical Journal, 319, 612615.
Robinson, G. L., Gilbertson, A. D. & Litwack, L. (1986) The effects of a psychiatric patient education to medication program on post-discharge compliance. Psychiatric Quarterly, 58, 113118.
Spooren, D., Van Heeringen, C. & Jannes, C. (1998) Strategies to increase compliance with out-patient aftercare among patients referred to a psychiatric emergency department: a multi-centre controlled intervention study. Psychological Medicine, 28, 949956.
Wilkinson, G., Allen, P., Marshall, E., et al (1993) The role of the practice nurse in the management of depression in general practice: treatment adherence to antidepressant medication. Psychological Medicine, 23, 229237.
Yousef, F. A. (1983) Compliance with therapeutic regimens: a follow-up study for patients with affective disorders. Journal of Advanced Nursing, 8, 513517.
Anderson, I. M. (1998) SSRIs versus tricyclic antidepressants in depressed inpatients: a meta-analysis of efficacy and tolerability. Depression and Anxiety, 7 (suppl. 1), 1117.
Anderson, I. M. & Tomenson, B. M. (1995) Treatment discontinuation with selective serotonin reuptake inhibitors compared with tricyclic antidepressants: a meta-analysis. British Medical Journal, 310, 14331438.
Bollini, P., Pampallona, S., Tibaldi, G., et al (1999) Effectiveness of antidepressants. Meta-analysis of dose – effect relationships in randomised clinical trials. British Journal of Psychiatry, 174, 297303.
Bruer, J. T. (1982) Methodological rigor and citation frequency in patient compliance literature. American Journal of Public Health, 72, 11191123.
Demyttenaere, K. (1997) Compliance during treatment with antidepressants. Journal of Affective Disorders, 43, 2739.
Greenberg, R. P. & Fisher, S. (1997) Mood-mending medicines: probing drugs, psychotherapy, and placebo solutions. In From Placebo to Panacea, Putting Psychiatric Drugs to the Test (eds Fisher, S. & Greenberg, R. P.), pp. 115172. New York: John Wiley & Sons.
Haynes, R. B., McKibbon, K. A. & Kanani, R. (1996) Systematic review of randomised trials of interventions to assist patients to follow prescriptions for medications. Lancet, 348, 383386.
Kendrick, T. (2000) Depression management clinics in general practice? Some aspects lend themselves to the mini-clinic approach. British Medical Journal, 320, 528529.
Montgomery, S. A. & Kasper, S. (1995) Comparison of compliance between serotonin reuptake inhibitors and tricyclic antidepressants: a meta-analysis. International Clinical Psychopharmacology, 9, 3340.
Nichol, M. B., Venturini, F. & Sung, J. C. V. (1999) A critical evaluation of the methodology of the literature on medication compliance. Annals of Pharmacotherapy, 33, 531540.
Steffens, D. C., Krishnan, K. R. & Helms, M. J. (1997) Are SSRIs better than TCAs? Comparison of SSRIs and TCAs: a meta-analysis. Depression and Anxiety, 6, 1018.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Patient adherence in the treatment of depression

  • S. Pampallona (a1), P. Bollini (a1), G. Tibaldi (a2), B. Kupelnick (a2) and C. Munizza (a2)...
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