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Treatment-Related Factors for Medication Non-Adherence Among Patients with Major Depressive Disorder: An Explanatory

Sohail Riaz1, Fazli Khuda2, Asif Jan2,3

  • 1Department of Pharmacy Practice, Faculty of Pharmacy, Capital University of Science and Technology, Islamabad, Pakistan.

Patient Preference and Adherence
|May 4, 2026
PubMed
Summary

Treatment barriers like side effects and poor pharmacy support contribute to antidepressant non-adherence in Pakistani patients with Major Depressive Disorder (MDD). Culturally sensitive interventions are crucial for improving adherence and outcomes.

Keywords:
adverse drug reactionsantidepressantsmajor depressive disordermedication non-adherencemixed-methods study

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Area of Science:

  • Psychiatry and Mental Health
  • Pharmacovigilance
  • Health Services Research

Background:

  • Major Depressive Disorder (MDD) is a prevalent mental health condition.
  • Antidepressant non-adherence is a significant challenge in managing MDD, leading to poorer patient outcomes.
  • Understanding treatment-related factors influencing adherence is crucial, especially in diverse cultural and resource settings.

Purpose of the Study:

  • To investigate treatment-related factors associated with antidepressant non-adherence among patients diagnosed with Major Depressive Disorder (MDD) in Pakistan.
  • To identify predictors of non-adherence in this specific patient population.

Main Methods:

  • An explanatory sequential mixed-methods cross-sectional study design was utilized.
  • Quantitative phase involved surveying 2,513 MDD patients to assess non-adherence and its predictors.
  • Qualitative phase included semi-structured interviews with 17 poorly adherent participants to explore contextual experiences.

Main Results:

  • Over 32% of participants exhibited poor antidepressant adherence.
  • High Adverse Drug Reaction (ADR) burden, low medication adherence scores, unemployment, low income, and older age were linked to non-adherence.
  • Qualitative data highlighted sedation, weight gain, cultural beliefs, and inadequate support as key barriers.

Conclusions:

  • Physiological, cognitive, and systemic barriers significantly impact antidepressant adherence in Pakistani MDD patients.
  • Culturally sensitive ADR counseling, regular follow-ups, and pharmacist support are recommended to enhance adherence and treatment outcomes in low-resource settings.