Factors predicting adherence to antidepressant treatment

Area of Science:

• Psychiatry
• Pharmacology
• Medical Sociology

Background:

• Poor adherence and discontinuation of antidepressant treatment present significant challenges in managing depression.
• Identifying predictors of treatment adherence and persistence is essential for improving patient outcomes.

Purpose of the Study:

• To review recent factors predicting adherence to and persistence of antidepressant treatment in patients with depression.
• To synthesize findings on predictors across diverse patient subgroups and comorbid conditions.

Main Methods:

• Review of recent literature on antidepressant treatment adherence and persistence.
• Analysis of studies including subgroups of patients with depression and those with comorbid medical conditions.
• Inclusion of studies utilizing medical claims databases.

Main Results:

• Common predictors include socio-demographic variables, depression severity, comorbidities, pharmacological aspects, patient attitudes, treatment history, patient-professional relationship, and genetic factors.
• Positive predictors of adherence/persistence: older age, positive attitudes towards antidepressants, prior personal or vicarious treatment experiences.
• Negative predictors of adherence/persistence: minority status, low income, pregnancy, side effects, treatment dissatisfaction, poor patient-professional relationship.

Conclusions:

• Factors influencing antidepressant adherence and persistence are complex and interconnected.
• Current study methodologies have limitations in comprehensively exploring all predictive factors.
• Future research should integrate these factors and investigate subgroup-specific predictors for depression pharmacotherapy.