An Analysis of Factors Affecting Postnatal Depression Intervention Adherence

Abstract

Adjunct mobile support for postnatal depression could promote treatment adherence and long-term maintenance of behavioural change. The aim of this article is to establish the factors that determine adherence to postnatal depression intervention and support. Also, this article is intended to establish attitudes that women have towards postnatal depression intervention and support. Eighty-four women with a previous diagnosis of postnatal depression completed an online questionnaire on their previous use of postnatal depression intervention and factors inhibiting adherence, as well as attitudes towards the intervention. Results showed that adjunct support and combining multiple interventions would improve adherence. The provision of treatment guidance will also positively enhance treatment uptake and retention. Therefore, these factors should be considered for the development of theory-based adjunct mobile application for postnatal depression.

Association between Intervention Delivery Approach for Postnatal Depression and its Subsequent Adherence

“…The transportation problem and childcare difficulties highlighted in these studies are consistent with the findings of other authors [25,36]. These might be as a result of the delivery location or schedule [20]. However, the effect of delivery location of PND adherence needs to be further investigated and addressed [38].…”

“…Furthermore, Interpersonal Therapy (IPT) has also been found to be effective for this population [17]. However, the postnatal period still presents specific barriers to adequate improvement in depression, and a large number of women remain without treatment, poorly adhere to the prescribed intervention or show only moderate improvement in depression [18][19][20].…”

“…Adherence is defined as the extent to which a person's behaviour conforms to medical or health advice [21,22]. A systematic review on patient adherence in the treatment of depression confirmed that adherence is a major problem with one in three patients not completing their prescribed treatment [20,22]. Receiving treatment for PND and sustaining it over the long-term has been proven to be very difficult due to barriers.…”

Healthcare Professionals' Perceptions of Factors That Could Inform Adherence Interventions for Postnatal Depression Treatments

“…Furthermore, as a general rule, the more favourable the attitude or subjective norm, and the greater the perceived behavioural control, the stronger should be the person's intention to perform the behaviour (Ajzen, 2011). Previous studies have identified women's attitudes and beliefs toward PND intervention (Omisade, Good, Fitch & Briggs, 2018a, 2018b. However, we assume that the healthcare professional (subjective norms) are significant and could significantly influence techniques and women's decision to adhere to prescribed PND treatments.…”

“…Non-adherence has been identified as a critical factor impeding increased treatment outcomes for PND (Cuijpers et al, 2008;De Graaf et al, 2009;Dennis & Chung-Lee, 2006;Gonzalez et al, 2005;Omisade et al, 2020;Pampallona et al, 2002). This can increase the cost of service in financial terms and in the investment of time and effort.…”