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Medication non-adherence in depression: a systematic review and metanalysis
Roseane Halkjaer Lassen1, Walter Gonçalves1, Bruno Gherman1
1Ambulatório de Depressão Resistente ao Tratamento, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.
Trends in Psychiatry and Psychotherapy
|January 9, 2024
Summary
A significant portion of individuals with major depressive disorder (MDD) do not adhere to their antidepressant medication. This systematic review found a 42% non-adherence rate, highlighting a critical issue in depression treatment.
Area of Science:
- Psychiatry and Mental Health
- Pharmacology
- Evidence-Based Medicine
Background:
- Medication non-adherence is a significant challenge in managing major depressive disorder (MDD).
- Understanding the prevalence of antidepressant non-adherence is crucial for improving treatment outcomes in MDD patients.
Approach:
- A systematic review and meta-analysis were conducted following PRISMA guidelines.
- Eleven eligible studies were analyzed, assessing antidepressant adherence in MDD using various methods.
- Data were synthesized using a random effects model with subgroup analysis.
Key Points:
- The pooled prevalence of non-adherence to antidepressants in MDD was 42% (95% CI 30%-54%).
- Assessment methods for non-adherence varied widely, including self-report scales, pharmacy records, MEMS, and blood tests.
- High heterogeneity (I²=99%) was observed across the included studies.
Conclusions:
- A substantial number of patients with MDD do not take their antidepressant medication as prescribed.
- The heterogeneity in adherence assessment methods may contribute to the wide variability in reported non-adherence rates.
- Addressing medication adherence is essential for healthcare professionals to enhance treatment efficacy in major depression.
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