Persistence and compliance to antidepressant treatment in patients with depression: A chart review

Norifusa Sawada, Hiroyuki Uchida, Takefumi Suzuki, Koichiro Watanabe, Toshiaki Kikuchi, Takashi Handa, Haruo Kashima

Research output: Contribution to journalArticle

104 Citations (Scopus)

Abstract

Background: Adherence has recently been suggested to be divided into these two components: persistence (i.e., whether patients continue treatment or not) and compliance (i.e., whether patients take doses as instructed). However, no study has yet assessed these two clinically relevant components at the same time in adherence to antidepressant treatment in the clinical outpatient setting. Methods: In this retrospective chart-review, 6-month adherence to antidepressants was examined in 367 outpatients with a major depressive disorder (ICD-10) (170 males; mean ± SD age 37.6 ± 13.9 years), who started antidepressant treatment from April 2006 through March 2007. Additionally, we evaluated Medication Possession Rate (MPR), defined as the total days a medication was dispensed to patients divided by the treatment period. Results: Only 161 patients (44.3%) continued antidepressant treatment for 6 months. Among 252 patients who discontinued their initial antidepressant, 63.1% of these patients did so without consulting their physicians. Sertraline use was associated with a higher persistence rate at month 6 (odds ratio 2.59 in comparison with sulpiride), and the use of anxiolytic benzodiazepines had a positive effect on persistence to antidepressant treatment only at month 1 (odds ratio 2.14). An overall MPR was 0.77; 55.6% of patients were considered compliant (i.e., a MPR of ≥ 0.8). Conclusion: Given a high rate of antidepressant discontinuation without consulting their physicians, closer communication between patients and their physicians should be encouraged. Although the use of anxiolytic benzodiazepines was associated with a higher persistence to antidepressant treatment at month 1, the use of these drugs should be avoided as a rule, given their well-known serious adverse effects.

Original languageEnglish
Article number38
JournalBMC Psychiatry
Volume9
DOIs
Publication statusPublished - 2009 Jun 16

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Antidepressive Agents
Depression
Anti-Anxiety Agents
Therapeutics
Physicians
Benzodiazepines
Outpatients
Odds Ratio
Sertraline
Sulpiride
Major Depressive Disorder
International Classification of Diseases
Compliance
Communication
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Psychiatry and Mental health

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Persistence and compliance to antidepressant treatment in patients with depression : A chart review. / Sawada, Norifusa; Uchida, Hiroyuki; Suzuki, Takefumi; Watanabe, Koichiro; Kikuchi, Toshiaki; Handa, Takashi; Kashima, Haruo.

In: BMC Psychiatry, Vol. 9, 38, 16.06.2009.

Research output: Contribution to journalArticle

Sawada, Norifusa ; Uchida, Hiroyuki ; Suzuki, Takefumi ; Watanabe, Koichiro ; Kikuchi, Toshiaki ; Handa, Takashi ; Kashima, Haruo. / Persistence and compliance to antidepressant treatment in patients with depression : A chart review. In: BMC Psychiatry. 2009 ; Vol. 9.
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