The influence of Hispanic ethnicity on patients' expression of complaints about and problems with adherence to...

Although Hispanics constitute the most rapidly growing ethnic group in the United States, few studies have examined the relationship between Hispanic ethnicity and patients' experiences with the use of antidepressant medications.

The purpose of this study was to examine the influence of Hispanic ethnicity on patients' expression of complaints about and problems of adherence with antidepressant medications and physicians' reactions to these complaints and adherence problems.

Data were collected as part of a larger cross-sectional study of physician-patient communication conducted during 1995 in the general medicine and family practice clinics of the University of New Mexico. Between March and December 1995, patients' medical visits were recorded on audiotape, patients were interviewed after each visit, and patients' medical records were reviewed. The present analysis focused on patients who received a prescription for an antidepressant on the day of the audiotaped visit. Because this was a cross-sectional study, only 1 visit was recorded for each patient.

Ninety-eight patients were identified who received a new or refill prescription for an antidepressant on the day of the audiotaped visit. Twenty-eight (28.6%) patients expressed a complaint about their antidepressant therapy. Younger patients and non-Hispanic white patients were more likely to express such a complaint than were older patients and Hispanic patients. Ten (10.2%) patients reported an adherence problem. Patients who rated their physical health as better were more likely to express adherence problems with antidepressant therapy than were patients who rated their physical health was worse. Physicians were generally responsive to patients' expression of complaints and adherence problems.

Patients' ethnicity was related to their expression of complaints about antidepressant therapy but not to their expression of adherence problems or to physicians' reactions on patients' expression of either. Because many patients express complaints about and adherence problems with antidepressant therapy, providers should be prepared to educate patients about their prescribed therapy or change the antidepressant regimen.