Treatment and Disease Related Factors Affecting Non-adherence among Patients on Long Term Therapy of Antidepressants

Abstract

Introduction: Depression is a term used to describe a health problem in which mood pattern will be affected. Clinical depression is more severe and the symptoms can continue for weeks, months, and even years in some cases if it is not treated and it does interfere with our ability to function and it also can leads to suicide at its worst. Although clinical guidelines recommend antidepressants be continued for at least 6 months after symptom remission, approximately one third of patients discontinue antidepressants within the first month of treatment, and 44% discontinue them by the third month of treatment. Adherence to antidepressants is a stimulating problem in the management of patients with depression. Various factors such as nature and duration of therapy, disease characteristics, medication side-effects, cost of treatment, characteristics of health service facilities, the relation among the physician and patient, patient characteristics such as socioeconomic factors, patient's perspective about the illness and treatment have been reported to influence adherence.

Self-Reported Adverse Drug Reactions, Medication Adherence, and Clinical Outcomes among Major Depressive Disorder Patients in Ethiopia: A Prospective Hospital Based Study

“…A ten-year cumulative evidence reported that approximately fifty percent of depression patients discontinue their medications [ 28 ]. Sriharsha (2015) has reported that various factors such as duration of therapy and disease were found to influence adherence [ 29 ]. Our study has also found that long-standing depression and comorbid psychiatric features increased the chance of nonadherence.…”

Adherencia farmacológica en relación con funcionalidad familiar en el tratamiento ambulatorio de pacientes con esquizofrenia, depresión y trastorno bipolar.

“…En cuanto a la depresión no se encontraron estudios en Colombia que midieran la adherencia a los antidepresivos; sin embargo, en India, un importante estudio transversal de 103 pacientes psiquiátricos con diagnóstico de depresión unipolar reportó un 44% con deficiente adherencia farmacológica, agregado a un 26% con una "justa" adherencia, la cual agrupan como no-adherente. No fue significativo el tipo de medicamento, pero el estudio resalta el valor estadísticamente significativo de la polifarmacia oral (p< 0.043) (16). La polifarmacia se define simplemente como el uso de múltiples medicamentos por un paciente, aunque el número mínimo preciso de los medicamentos utilizados para definir "polifarmacia" es variable.…”

Prevalence, Barriers, and Interventions related to Medication Adherence Among Patients Diagnosed with Major Depressive Disorder: A Scoping Review

“…15 Despite the existence of effective treatments, successful treatment, and response remain sub-optimal. 16 Over 20 years, adherence to medications in MDD has been an intractable clinical challenge. 17 Despite the high rate of medication nonadherence, there is a variation of adherence rate related to various methods used to measure medication adherence including self-reported, pill counts, pharmaceutical claims, biomarkers, physiological measures, and electronic medication monitoring.…”

“…16 Over 20 years, adherence to medications in MDD has been an intractable clinical challenge. 17 Despite the high rate of medication nonadherence, there is a variation of adherence rate related to various methods used to measure medication adherence including self-reported, pill counts, pharmaceutical claims, biomarkers, physiological measures, and electronic medication monitoring. 4,18 Moreover, adherence to medication has been influenced by complex and multidimensional factors as barriers to reach successful treatment that includes patientrelated, therapy-related, healthcare system, condition-related, and socioeconomic factors.…”

“…Nonadherent patients with MDD have a high risk of relapse and recurrence, rehospitalization, decreased reduction in the severity of depression, and growing suicidal ideation. 16,25 Although, previous literature has pointed out to optimize adherence to medication through designing and implement appropriate medication adherence enhancing interventions. 22,26,27 Indeed, different interventions help the enhancement of medication adherence, 28,29 include psychoeducation, motivational interviewing, psychosocial interventions, behavioral interventions, cognitive interventions, and cognitive-behavioral approaches.…”