‘Just keep taking the tablets’: adherence to antidepressant treatment in older people in primary care
Abstract
Background: Poor adherence to antidepressant medication may account for a significant proportion of treatment failures. Adherence levels and factors associated with adherence have not previously been studied in older people. Objectives: To report the prevalence and correlates of adherence to antidepressants in people ≥ 65 years of age in a primary care setting. Method: Sixty‐seven patients currently being prescribed antidepressants from a single rural general practice were assessed using a range of questionnaires measuring adherence to antidepressants, severity of depression, specific health education about antidepressants, level of side‐effects, insight, positive and negatives beliefs about medication in general and antidepressants in particular, level of intellectual functioning (past and present), a past history of recovery from depression, type of antidepressant, complexity of prescriptions, age and living arrangements. Results: Forty‐five participants (67.2%) were fully adherent; seven (10.4%) mostly adherent, three (4.5%) adhered sometimes, three rarely and nine (13.4%) never. Backwards linear regression found that adherence increased with information given and cognitive impairment and decreased with concerns about taking antidepressants and severity of side‐effects. Conclusions: Non‐adherence to antidepressant medication is a significant problem in older patients. Our study probably overestimated adherence as it was self‐report, which usually overestimates adherence and the refusals are more likely to have been people not taking tablets but still found nearly one third of the patients were non‐adherent. An intervention comprising education, eliciting and addressing specific concerns about antidepressant medication and using medication, which minimises side effects, may be helpful. Copyright © 2002 John Wiley & Sons, Ltd.
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Self-report is the most common means of evaluating the responsiveness of all participants to an intervention.
“Self-report is the most common means of evaluating the responsiveness of all participants to an intervention [30-34,37].”
From A conceptual framework for implementation fidelity (2007) · cites this paper as [31]
Implementation fidelity of prescribed drug interventions for elderly people in the community can be low because these patients deliberately fail to comply with their prescribed regimens.
“it has been found that implementation fidelity of prescribed drug interventions for elderly people in the community can be low because these patients deliberately fail to comply with their prescribed regimens [31-33].”
From A conceptual framework for implementation fidelity (2007) · cites this paper as [31]
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- Authors
- Maidment, R., Livingston, G., & Katona, C.
- Affiliations
- The Royal Free Hospital (GB)
- Corresponding author
- Katona, Cornelius
- Venue
- International Journal of Geriatric Psychiatry
- Publisher
- Wiley
- Published
- 2002-07-22
- Volume
- 17
- Issue
- 8
- Pages
- 752-757
- ISSN
- 0885-6230 (ISSN-L)
- 1099-1166
- OpenAlex
- W2041260165
- Cited by
- 116
- References
- 31
- Citations by year
- 2025: 2 · 2024: 2 · 2023: 3 · 2022: 7 · 2021: 1 · 2020: 3 · 2019: 1 · 2018: 2 · 2017: 4 · 2016: 2 · 2015: 7 · 2014: 5 · 2013: 9 · 2012: 8
- FWCI
- 5.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Kent Academic Repository (University of Kent) (submittedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- antidepressant adherence, medication non-adherence, older adults, depression, primary care, cognitive impairment, adverse effects, health education, medication beliefs, self-report adherence
- MeSH terms
- Aged, Aged, 80 and over, Antidepressive Agents, Cognition Disorders, Depressive Disorder, Female, Humans, Male, Neuropsychological Tests, Patient Compliance, Surveys and Questionnaires, Rural Population, Prevalence
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