Risk factors for non-adherence to antidepressant treatment in patients with mood disorders

Cuevas, Carlos De las; Peñate, Wenceslao; Sanz, Emilio J.

doi:10.1007/s00228-013-1582-9

Cited by 69 publications

(57 citation statements)

References 41 publications

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“…Concordance between patient preferences and experiences in clinical decision making is likely to increase the satisfaction in the relationship and the confidence in the doctor. On the contrary, a lack of concordance may exacerbate psychological reactance in psychiatric patients, an aversive motivational state known to influence in a negative way the involvement of patients in health behaviors, treatment adherence, and relapse 26–29. Further studies about congruence and mismatch between doctor and patient attitudes in medical decision making are relevant for practice.…”

Section: Discussionmentioning

confidence: 99%

To what extent is treatment adherence of psychiatric patients influenced by their participation in shared decision making?

Cuevas¹,

Peñate²,

Rivera³

2014

PPA

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RationaleNonadherence to prescribed medications is a significant barrier to the successful treatment of psychiatric disorders in clinical practice. It has been argued that patient participation in shared decision making improves adherence to treatment plans.PurposeTo assess to what extent treatment adherence of psychiatric patients is influenced by the concordance between their preferred participation and their actual participation in decision making.Materials and methodsA total of 967 consecutive psychiatric outpatients completed the Control Preference Scale twice consecutively before consultation, one for their preferences of participation, and the other for the style they had usually experienced until then, and the eight-item self-report Morisky Medication Adherence Scale 8.ResultsMost psychiatric outpatients preferred a collaborative role in decision making. Congruence was achieved in only 50% of the patients, with most mismatch cases preferring more involvement than had been experienced. Self-reported adherence was significantly higher in those patients in whom there was concordance between their preferences and their experiences of participation in decision making, regardless of the type of participation preferred.ConclusionCongruence between patients’ preferences and actual experiences for level of participation in shared decision making is relevant for their adherence to treatment.

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Section: Discussionmentioning

confidence: 99%

To what extent is treatment adherence of psychiatric patients influenced by their participation in shared decision making?

Cuevas¹,

Peñate²,

Rivera³

2014

PPA

Self Cite

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“…These rates are alarming, considering that guidelines suggest taking antidepressant medication for at least 6 to 9 months to prevent relapse after the remission of a depressive episode (Cleare et al 2015). Several factors contributing to patients’ non-adherence have been identified (Serna et al 2010; De las Cuevas et al 2014; Bocquier et al 2014), but one particular factor emerges consistently as a reason for discontinuing antidepressants, namely, side effects (e.g., Serna et al 2010; Hung et al 2011; Murata and Kanbayashi 2012; De las Cuevas et al 2014). Common side effects of antidepressants (i.e., pharmacological reactions due to drug intake that differ from those intended) are, for instance, daytime sleepiness, dry mouth, loss of interest in sexual activity, and weight gain (Ashton et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Learning to experience side effects after antidepressant intake – Results from a randomized, controlled, double-blind study

et al. 2016

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BackgroundSide effects play a key role in patients’ failure to take antidepressants. There is evidence that verbal suggestions and informed consent elicit expectations that can in turn trigger the occurrence of side effects. Prior experience or learning mechanisms are also assumed to contribute to the development of side effects, although their role has not been thoroughly investigated. In this study, we examined whether an antidepressant’s side effects can be learned via Pavlovian conditioning.MethodsParticipants (n = 39) were randomly allocated to one of two groups and were exposed to a classical conditioning procedure. During acquisition, 19 participants received amitriptyline and 20 participants received a placebo pill. Pills were taken for four nights together with a novel-tasting drink. After a washout phase, both groups received a placebo pill together with the novel-tasting drink (evocation). Side effects were assessed via the Generic Assessment of Side Effects Scale prior to acquisition (baseline), after acquisition, and after evocation. A score of antidepressant-specific side effects was calculated.ResultsParticipants taking amitriptyline reported significantly more antidepressant-specific side effects after acquisition compared to both baseline and the placebo group. After evocation, participants who underwent the conditioning procedure with amitriptyline reported significantly more antidepressant-specific side effects than those who never received amitriptyline, even though both groups received a placebo.ConclusionsOur results indicate that antidepressant side effects can be learned using a conditioning paradigm and evoked via a placebo pill when applied with the same contextual factors as the verum.

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“…Psychological factors that have been associated with poorer adherence include lack of social support and self-efficacy regarding the use of one’s antidepressant (2, 8). Increasing severity of depressive symptoms and both the presence and severity of antidepressant side-effects have been associated with poorer adherence (9). Taking multiple medications or using a combination treatment for depression has also been associated with adherence, though results are inconsistent regarding the direction of the effect (10).…”

mentioning

confidence: 99%

Predictors of Pharmacy-Based Measurement and Self-Report of Antidepressant Adherence: Are Individuals Overestimating Adherence?

Leggett

Ganoczy

Zivin

et al. 2016

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Objective The current study considers demographic, social, psychological, and clinical factors as predictors of adherence over time using both the Brief Medication Questionnaire (BMQ) based on self-report and medication possession ratios (MPRs) based on administrative pharmacy-data. Methods Adherence was assessed at 6 and 12 months among veterans in ongoing treatment for depression in a trial of peer support. Logistic regression models were utilized to consider predictors of adequate adherence. Results At 6 and 12 months, 36% and 35% of patients had poor adherence based on MPRs while 24% and 18% had poor adherence based on self-report. Poor adherence based on MPRs was more likely among men, non-whites, and those of Hispanic ethnicity. Poor self-reported adherence was more likely with increased depressive symptoms and unemployment. Conclusions These adherence measures may be complementary. Strategies to improve adherence might target specific demographic groups and those experiencing unemployment and higher levels of depressive symptoms.

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Risk factors for non-adherence to antidepressant treatment in patients with mood disorders

Cited by 69 publications

References 41 publications

To what extent is treatment adherence of psychiatric patients influenced by their participation in shared decision making?

To what extent is treatment adherence of psychiatric patients influenced by their participation in shared decision making?

Learning to experience side effects after antidepressant intake – Results from a randomized, controlled, double-blind study

Predictors of Pharmacy-Based Measurement and Self-Report of Antidepressant Adherence: Are Individuals Overestimating Adherence?

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