Concordance therapy: an intervention to help older people take antidepressants

Older people often do not adhere fully to antidepressant medication. Compliance Therapy improves adherence with antipsychotic medication.

To adapt Compliance Therapy for use in older depressed patients, to pilot this 'Concordance Therapy' for feasibility and acceptability and to gain preliminary indications of its efficacy.

Randomised controlled trial (RCT).

Psychiatric services for older people in North London and Essex.

A total of 19 older depressed patients.

10 patients received Concordance Therapy over 3-4 sessions.

9 patients received treatment as usual.

medication adherence at 1 month.

medication adherence at 3 months; depression severity, beliefs about medication, quality of life at 1 and 3 months; patient feedback about the therapy.

The therapy was acceptable to patients. INTERVENTION patients were more likely to take antidepressants, had a higher quality of life, had less depressive symptomatology and were less likely to be cases of depression at 1 month. Beliefs around antidepressants at 1 month were more positive in the intervention group but this was not the case for medication in general.

As a pilot, patient numbers were small and the findings did not reach statistical significance. Three patients (1 intervention, 2 control) were in hospital and therefore offered medication at follow-up.

Concordance Therapy for older people prescribed antidepressants is acceptable and feasible and shows sufficient promise of efficacy to justify an adequately powered RCT.