Medication Adherence and Persistence in Patients with Severe Major Depressive Disorder with Psychotic Features: Antidepressant and Second-Generation Antipsychotic Therapy Versus Antidepressant Monotherapy

Kim-Romo, Dawn N.; Rascati, Karen L.; Richards, Katherine; Ford, Kentya C.; Wilson, James P.; Beretvas, S. Natasha

doi:10.18553/jmcp.2016.22.5.588

Cited by 9 publications

(7 citation statements)

References 33 publications

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“…The results that the mean of the MPR and the LOT increased in patients who continued to receive IP and that females with depression have a higher percentage of adherence and persistence than men is similar to previous studies [ 44 , 45 ]. However, in terms of age groups, an opposite result was observed compared with previous work [ 11 , 22 , 23 ]. The studies of Olfson et al (2006) and Akincigil et al (2007) were measured using patient questionnaires, and in other antidepressant studies, the result of age was interpreted because several factors, such as education and stigma, could be reflected [ 3 , 44 ].…”

Section: Discussioncontrasting

confidence: 84%

“…The MPR was defined as the number of days the patient possessed the study medication, divided by the observation period of 180 days [ 20 , 21 ]. An adherent patient was defined as an MPR being more than or equal to 0.8 [ 22 , 23 ]. The LOT, which measures the duration of time from the initiation to the discontinuation of therapy, was defined as the number of days from the index date to the earliest ending date of the last prescription, with the permissible gap being 14 days [ 23 , 24 ].…”

Section: Methodsmentioning

confidence: 99%

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The Impact of Payment Scheme Changes on Medication Adherence and Persistence of Patients Diagnosed with Depression in Korea

Shin

Jang

Bae

et al. 2022

IJERPH

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As of 1 July 2018, the Korean National Health Insurance Service (NHIS) changed the fee schedule for individual psychotherapy (IP). We sought to analyze the impact of the IP payment scheme changes on the medication adherence and persistence of patients diagnosed with depression in Korea. We utilized the NHIS claims database from 2017 to 2019. Patients who were newly diagnosed with depression and utilized IP and were prescribed antidepressants during the study period were included. Adherence was measured using the medication possession ratio (MPR), and persistence was measured using the length of therapy (LOT) during the follow-up period. Adherence and persistence during the pre-policy period (before the change of the payment scheme, from January 2018 until June 2018) and the post-policy period (after the change, from July 2018 until December 2019) were compared. During the study period, a total of 176,740 patients with depression were identified. The average MPR significantly increased from 0.20 to 0.33 in the pre- and post-policy periods, respectively (p < 0.001). The average LOT of the patients improved considerably from 36 to 56 days in the pre- and post-policy periods, respectively (p < 0.001). Poisson regression analysis showed that patients with depression who were female, 19–34 years of age (vs. 50–64 years or over 64 years), and in the post-policy period were significantly associated with greater adherence and persistence rates. Payment scheme changes were associated with an increased adherence and persistence of medication use among patients diagnosed with depression.

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Section: Discussioncontrasting

confidence: 84%

Section: Methodsmentioning

confidence: 99%

The Impact of Payment Scheme Changes on Medication Adherence and Persistence of Patients Diagnosed with Depression in Korea

Shin

Jang

Bae

et al. 2022

IJERPH

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“…[10][11][12] African Americans (AA) show greater concerns of AD use, less understanding of treatment, and less adherence when compared to non-Hispanic whites. [13][14][15] Hispanic culture's unique barriers, stigma, and beliefs may lead to greater non-adherence to antidepressants. 16,17 For instance, one study found that Hispanic's belief of familismo may be leading to non-adherence.…”

Section: Non-adherence Risk Factorsmentioning

confidence: 99%

Antidepressant Adherence Among Hispanics: Patients in an Integrated Health Care Model

Kunz-Lomelin¹,

Killian²,

Eghaneyan³

et al. 2022

JMDH

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Purpose We report on antidepressant (AD) adherence among Hispanics seeking mental health services in a community primary care clinic in Texas as an ancillary outcome from a National Institutes of Health-funded study that collected data on Hispanic AD adherence over a period of two years (February 2016–February 2018). Adherence to AD medications was measured throughout the year-long trial and compared across various demographic characteristics. Since Hispanic individuals often experience stigma and cultural barriers related to AD treatment, we sought to understand what factors may increase the likelihood of non-adherence in this population. Patients and Methods This study focused on 69 patients who were prescribed AD medications while receiving treatment through an integrated health care model. Adherence was measured with the Patient Adherence Questionnaire, a validated 2-item questionnaire that asks patients about their medication use (missed medications or dosage changes) over the past week. We looked at patient adherence at two key time points (4-weeks and 13-weeks) and utilized logistic regression to identify factors that may increase or decrease the likelihood of adherence in Hispanic patients at a community primary care clinic. Results Non-adherence to AD medication was 49.3% at 4-weeks and 57% at 13-weeks post-treatment initiation. Logistic regression analyses revealed that age was the only significant predictor of AD non-adherence. As age increased, the likelihood of adherence increased by 12.2% at 13-weeks post-treatment initiation and by 11.1% at 4-weeks post-treatment initiation. Conclusion The likelihood of Hispanic patients to adhere to AD therapy increased with the age of the patient. Since primary care is the most likely place to be prescribed an AD for Hispanic patients, further research to better understand adherence is essential. Integrated health care interventions designed to help identify, reduce, or eliminate barriers to adherence and improve cultural understanding may help address issues of non-adherence in primary care settings.

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“…Antipsychotics augment antidepressants in 12-32% of older adults with depression [3][4][5][6], albeit in most cases in an off-label manner [7]. Antipsychotics contribute not only to treating psychotic symptoms in severe depression with psychotic features [8], but also to depressive symptom improvement, since they enhance monoaminergic neurotransmission [9].…”

Section: Introductionmentioning

confidence: 99%

Differences in cause and 12-month follow-up outcome of parkinsonian symptoms in depressed older adults treated with antipsychotics: a case series

et al. 2021

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Background Parkinsonian symptoms are common adverse effects of antipsychotics. Older adults are particularly vulnerable to drug-induced parkinsonism. Nonetheless, parkinsonian symptoms in seniors treated with antipsychotics cannot be straightforwardly attributed to antipsychotic medication. A comprehensive diagnostic workup is necessary in many cases in order to shed light on the cause of such symptoms in this patient population. Case series Eight cases of hospitalized depressed older adults with parkinsonian symptoms, who were treated for at least one year with antipsychotics, are reported. Based on neurological consultation, structural brain imaging and Ioflupane (I-123) dopamine transporter (DAT) single photon emission computerized tomography (SPECT), Parkinson’s disease was diagnosed in one case, idiopathic tremor in another, vascular parkinsonism in another one, while in another individual parkinsonian symptoms persisted at 12-month post-discharge follow-up even though his/her symptoms were classified as drug-induced on discharge. In four patients, parkinsonian symptoms were definitely drug-induced and no movement disturbances were reported at follow-up. Conclusions Differences in the cause and outcome of parkinsonian symptoms in seniors treated with antipsychotics merit systematic and in-depth study considering the therapeutic and prognostic implications of an accurate detection of the cause of such symptoms. Familiarizing clinical psychiatrists with these differences could pave the way towards approaching seniors with severe, atypical and/or persistent parkinsonian symptoms in a more individualized diagnostic and therapeutic manner, and towards more cautious prescribing of antipsychotics in this age group.

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Medication Adherence and Persistence in Patients with Severe Major Depressive Disorder with Psychotic Features: Antidepressant and Second-Generation Antipsychotic Therapy Versus Antidepressant Monotherapy

Cited by 9 publications

References 33 publications

The Impact of Payment Scheme Changes on Medication Adherence and Persistence of Patients Diagnosed with Depression in Korea

The Impact of Payment Scheme Changes on Medication Adherence and Persistence of Patients Diagnosed with Depression in Korea

Antidepressant Adherence Among Hispanics: Patients in an Integrated Health Care Model

Differences in cause and 12-month follow-up outcome of parkinsonian symptoms in depressed older adults treated with antipsychotics: a case series

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