Compliance with Antidepressant Medication Treatment Among Primary Care Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/153661
Type:
Presentation
Title:
Compliance with Antidepressant Medication Treatment Among Primary Care Patients
Abstract:
Compliance with Antidepressant Medication Treatment Among Primary Care Patients
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Stuart, Gail, PhD
P.I. Institution Name:Medical University of South Carolina
Title:Professor
Objective: To evaluate strategies to increase patient compliance with antidepressant medication prescribed in primary care settings. Design: Randomized controlled clinical trial. Population/Sample: 647 patients who met the following inclusion criteria: over 18 years of age; able to read English; not currently taking an antidepressant medication; newly prescribed an antidepressant medication by their primary care provider; access to a telephone; and willingness to participate in the study. Setting: 30 primary care settings throughout the United States that are members of the Practice Partner Research Network (PPRNet). A longitudinal database comprised of computerized medical records from approximately 180 participating clinicians forms the basis of PPRNet’s research activities. Years: Enrollment began in August 1998 and was concluded in June 1999. Patients were followed for one year following enrollment. Data collection was completed in August 2000. Study Variables: Baseline variables included: history of depression; demographics; primary and comorbid diagnoses; medications; and somatic symptoms. Covariates included: work productivity; functional status; depressive symptomatology; satisfaction with care; antidepressant medication prescribed; family support, and side effects. The primary outcome variable was compliance with medication treatment. The secondary outcome variables included: work productivity, functional status, depressive symptomatology, contacts with health care providers, and patient global impression of improvement. Methods: Study sites were randomly assigned to one of three interventions: 1) treatment team and patient self-care education; 2) treatment team and patient self-care education and office nurse telephone follow-up; or 3) treatment team and patient self-care education and telephone follow-up and an interactive voice response (IVR) telephone call program. Primary and secondary outcomes were assessed by telephone calls to patients from psychiatric nurse clinicians obtained at 2 weeks, and 2, 4, 6, 9 and 12 months. Findings: There were no significant differences in compliance among treatment arms but all three arms exceeded compliance rates reported in the literature at each outcome assessment time. Predictors of compliance included higher education, family support, satisfaction with care, greater number of baseline depression symptoms and patient impression of improvement at 2 weeks. Secondary outcome measures also improved for patients in all three treatment groups. Conclusions: Primary care patients with greater (5 or more) depressive symptoms are more likely to be compliant with antidepressant medication treatment. “Watchful waiting” appears to be an effective strategy for primary care patients with fewer (four or less) symptoms. Telephone calls to patients from psychiatric nurse clinicians increase compliance rates among all patients, while an IVR system does not appear to be a cost-effective strategy for enhancing compliance. Implications: Depression is a costly, common illness throughout the world that can be easily treated by primary care clinicians. Medication treatment may be most effective when prescribed to those primary care patients with more severe depressive symptoms. Telephone follow-up from nurse clinicians can enhance the clinical management of patients with depression and result in improved clinical outcomes.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleCompliance with Antidepressant Medication Treatment Among Primary Care Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/153661-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Compliance with Antidepressant Medication Treatment Among Primary Care Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Stuart, Gail, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Medical University of South Carolina</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">stuartg@musc.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: To evaluate strategies to increase patient compliance with antidepressant medication prescribed in primary care settings. Design: Randomized controlled clinical trial. Population/Sample: 647 patients who met the following inclusion criteria: over 18 years of age; able to read English; not currently taking an antidepressant medication; newly prescribed an antidepressant medication by their primary care provider; access to a telephone; and willingness to participate in the study. Setting: 30 primary care settings throughout the United States that are members of the Practice Partner Research Network (PPRNet). A longitudinal database comprised of computerized medical records from approximately 180 participating clinicians forms the basis of PPRNet&rsquo;s research activities. Years: Enrollment began in August 1998 and was concluded in June 1999. Patients were followed for one year following enrollment. Data collection was completed in August 2000. Study Variables: Baseline variables included: history of depression; demographics; primary and comorbid diagnoses; medications; and somatic symptoms. Covariates included: work productivity; functional status; depressive symptomatology; satisfaction with care; antidepressant medication prescribed; family support, and side effects. The primary outcome variable was compliance with medication treatment. The secondary outcome variables included: work productivity, functional status, depressive symptomatology, contacts with health care providers, and patient global impression of improvement. Methods: Study sites were randomly assigned to one of three interventions: 1) treatment team and patient self-care education; 2) treatment team and patient self-care education and office nurse telephone follow-up; or 3) treatment team and patient self-care education and telephone follow-up and an interactive voice response (IVR) telephone call program. Primary and secondary outcomes were assessed by telephone calls to patients from psychiatric nurse clinicians obtained at 2 weeks, and 2, 4, 6, 9 and 12 months. Findings: There were no significant differences in compliance among treatment arms but all three arms exceeded compliance rates reported in the literature at each outcome assessment time. Predictors of compliance included higher education, family support, satisfaction with care, greater number of baseline depression symptoms and patient impression of improvement at 2 weeks. Secondary outcome measures also improved for patients in all three treatment groups. Conclusions: Primary care patients with greater (5 or more) depressive symptoms are more likely to be compliant with antidepressant medication treatment. &ldquo;Watchful waiting&rdquo; appears to be an effective strategy for primary care patients with fewer (four or less) symptoms. Telephone calls to patients from psychiatric nurse clinicians increase compliance rates among all patients, while an IVR system does not appear to be a cost-effective strategy for enhancing compliance. Implications: Depression is a costly, common illness throughout the world that can be easily treated by primary care clinicians. Medication treatment may be most effective when prescribed to those primary care patients with more severe depressive symptoms. Telephone follow-up from nurse clinicians can enhance the clinical management of patients with depression and result in improved clinical outcomes.</td></tr></table>en_GB
dc.date.available2011-10-26T12:25:34Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T12:25:34Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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