‘Just keep taking the tablets’: adherence to antidepressant treatment in older people in primary care

✍ Scribed by Rachel Maidment; Gill Livingston; Cornelius Katona

• Publisher: John Wiley and Sons
• Year: 2002
• Tongue: English
• Weight: 88 KB
• Volume: 17
• Category: Article
• ISSN: 0885-6230
• DOI: 10.1002/gps.688

✦ Synopsis

Background:

Poor adherence to antidepressant medication may account for a significant proportion of treatment failures. adherence levels and factors associated with adherence have not previously been studied in older people.

Objectives:

To report the prevalence and correlates of adherence to antidepressants in people > or = 65 years of age in a primary care setting.

Method:

Sixty-seven patients currently being prescribed antidepressants from a single rural general practice were assessed using a range of questionnaires measuring adherence to antidepressants, severity of depression, specific health education about antidepressants, level of side-effects, insight, positive and negatives beliefs about medication in general and antidepressants in particular, level of intellectual functioning (past and present), a past history of recovery from depression, type of antidepressant, complexity of prescriptions, age and living arrangements.

Results:

Forty-five participants (67.2%) were fully adherent; seven (10.4%) mostly adherent, three (4.5%) adhered sometimes, three rarely and nine (13.4%) never. backwards linear regression found that adherence increased with information given and cognitive impairment and decreased with concerns about taking antidepressants and severity of side-effects.

Conclusions:

Non-adherence to antidepressant medication is a significant problem in older patients. our study probably overestimated adherence as it was self-report, which usually overestimates adherence and the refusals are more likely to have been people not taking tablets but still found nearly one third of the patients were non-adherent. an intervention comprising education, eliciting and addressing specific concerns about antidepressant medication and using medication, which minimises side effects, may be helpful.