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Related Experiment Video

Updated: Jun 28, 2026

Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation

Using Continuous Data Tracking Technology to Study Exercise Adherence in Pulmonary Rehabilitation

Published on: November 8, 2013

Working with reactant patients: are we prescribing nonadherence?

Joshua W Madsen¹, John R McQuaid, W Edward Craighead

¹Psychology Service, VA San Diego Healthcare System, La Jolla, California 92161, USA. joshua.madsen@va.gov

Depression and Anxiety

|October 31, 2008

Summary

Provider collaboration and patient reactance significantly impact antidepressant adherence in the first three weeks of treatment. Tailoring collaboration to patient reactance is key for early treatment success.

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Area of Science:

Psychiatry
Clinical Psychology
Health Services Research

Background:

Antidepressant nonadherence is common in depression treatment.
Psychosocial predictors of adherence require further investigation.
The role of provider collaboration and patient reactance in adherence is not well-studied.

Purpose of the Study:

To examine the interaction of provider collaboration and patient reactance in predicting antidepressant adherence.
To investigate adherence during the acute treatment phase of major depressive disorder.

Main Methods:

Fifty outpatients with major depressive disorder were assessed.
Predictor variables (provider collaboration, patient reactance) were measured via questionnaires.
Antidepressant adherence was monitored via telephone interviews over 12 weeks.
Multiple regression analyses were used to examine relationships.

Main Results:

The interaction of provider collaboration and patient reactance explained 18.3% of the variance in 3-week adherence.
High collaboration improved adherence in reactant patients; low collaboration improved adherence in less reactant patients.
These effects were significant only within the first three weeks of treatment.

Conclusions:

Interpersonal process variables significantly influence early antidepressant adherence.
A "blanket strategy" of increased collaboration may not be universally effective.
Tailoring collaboration to patient reactance can enhance early adherence, a critical period for antidepressant efficacy.