Improving adherence to sertraline treatment: the effectiveness of a patient education intervention

Previous attempts to improve anti-depressant adherence have achieved mixed results. The current study evaluated the effectiveness of a patient education intervention designed to increase adherence to sertraline treatment.

Data from a national pharmacy claims database were used to retrospectively match (along key demographic and clinical variables) consecutive patients prescribed sertraline (N = 1462) who received an educational intervention (Knowing More) between May 1, 2003, and April 30, 2004, with a control group of concurrent sertraline-treated patients who did not receive the intervention (N = 1462). The intervention consisted of 10 newsletters distributed over a 9-month period by mail and e-mail. The intervention and control groups were compared over a 7-month follow-up period on 3 adherence measures: time to discontinuation, days on therapy, and percentage of days on therapy.

Cox regression analysis revealed that the time to discontinuation of sertraline (median = 100 days) was significantly greater (p < .0001) for the intervention group compared with the control group (median = 60 days). By the end of the follow-up period, 27% of patients remained on therapy with Knowing More versus 15% of those not enrolled in the compliance program. The mean number of days on therapy was 24.8 days (25.5%) longer for the intervention group compared with the control group (122.5 days for the intervention group versus 97.7 days for the control group). The percentage of days on therapy was 88.2% for the intervention group versus 77.7% for the control group among patients with at least 1 refill prescription (p < .001).

The educational compliance intervention, Knowing More, was associated with a significant increase in adherence to antidepressant treatment.