Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial
AimTo assess the effectiveness of two interventions of knowledge transfer and behavior modification to improve medication adherence in patients with depressive disorders.MethodsAn open, multicenter, three-arm clinical trial with random allocation by cluster to usual care or to one of the two interve...
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1320159/full |
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| author | Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Himar González-Pacheco Himar González-Pacheco Himar González-Pacheco Beatriz González de León Beatriz González de León Pedro Serrano-Pérez Pedro Serrano-Pérez Pedro Serrano-Pérez Francisco Javier Acosta Artiles Francisco Javier Acosta Artiles Cristina Valcarcel-Nazco Cristina Valcarcel-Nazco Cristina Valcarcel-Nazco Isabel Hurtado-Navarro Isabel Hurtado-Navarro Cristobalina Rodríguez Álvarez María M. Trujillo-Martín María M. Trujillo-Martín María M. Trujillo-Martín María M. Trujillo-Martín on behalf of MAPDep Team |
| author_facet | Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Himar González-Pacheco Himar González-Pacheco Himar González-Pacheco Beatriz González de León Beatriz González de León Pedro Serrano-Pérez Pedro Serrano-Pérez Pedro Serrano-Pérez Francisco Javier Acosta Artiles Francisco Javier Acosta Artiles Cristina Valcarcel-Nazco Cristina Valcarcel-Nazco Cristina Valcarcel-Nazco Isabel Hurtado-Navarro Isabel Hurtado-Navarro Cristobalina Rodríguez Álvarez María M. Trujillo-Martín María M. Trujillo-Martín María M. Trujillo-Martín María M. Trujillo-Martín on behalf of MAPDep Team |
| author_sort | Tasmania del Pino-Sedeño |
| collection | DOAJ |
| description | AimTo assess the effectiveness of two interventions of knowledge transfer and behavior modification to improve medication adherence in patients with depressive disorders.MethodsAn open, multicenter, three-arm clinical trial with random allocation by cluster to usual care or to one of the two interventions. The intervention for psychiatrists (PsI) included an educational program based on a patient-centered care model. The intervention for patients and relatives (PtI) included a collaborative care program plus a reminder system that works using an already available medication reminder application. The primary outcome was patient adherence to antidepressant treatment assessed through the Sidorkiewicz Adherence Instrument. Secondary measures were depression severity, comorbid anxiety and health-related quality of life. Mixed regression models with repeated measures were used for data analysis.ResultsTen psychiatrists and 150 patients diagnosed with depressive disorder from eight Community Mental Health Units in the Canary Islands (Spain) were included. Compared with usual care, no differences in long-term adherence were observed in either group PsI or PtI. The PsI group had significantly improved depression symptoms (B = −0.39; 95%CI: −0.65, −0.12; p = 0.004) during the follow-up period. The PtI group presented improved depression symptoms (B = −0.63; 95%CI: −0.96, −0.30; p < 0.001) and mental quality of life (B = 0.08; 95%CI: 0.004, 0.15; p = 0.039) during the follow-up period.ConclusionThe assessed interventions to improve adherence in patients with depressive disorder were effective for depression symptoms and mental quality of life, even over the long term. However, no effect on antidepressant adherence was observed. |
| first_indexed | 2024-04-24T13:59:30Z |
| format | Article |
| id | doaj.art-e483ccf0cb984c53bf099bf70a10edd2 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-24T13:59:30Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-e483ccf0cb984c53bf099bf70a10edd22024-04-03T14:46:29ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-04-011210.3389/fpubh.2024.13201591320159Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trialTasmania del Pino-Sedeño0Tasmania del Pino-Sedeño1Tasmania del Pino-Sedeño2Tasmania del Pino-Sedeño3Himar González-Pacheco4Himar González-Pacheco5Himar González-Pacheco6Beatriz González de León7Beatriz González de León8Pedro Serrano-Pérez9Pedro Serrano-Pérez10Pedro Serrano-Pérez11Francisco Javier Acosta Artiles12Francisco Javier Acosta Artiles13Cristina Valcarcel-Nazco14Cristina Valcarcel-Nazco15Cristina Valcarcel-Nazco16Isabel Hurtado-Navarro17Isabel Hurtado-Navarro18Cristobalina Rodríguez Álvarez19María M. Trujillo-Martín20María M. Trujillo-Martín21María M. Trujillo-Martín22María M. Trujillo-Martín23on behalf of MAPDep TeamCanary Islands Health Research Institute Foundation (FIISC), Tenerife, SpainEvaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, SpainNetwork for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, SpainFaculty of Health Sciences, Universidad Europea de Canarias, Tenerife, SpainCanary Islands Health Research Institute Foundation (FIISC), Tenerife, SpainEvaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, SpainNetwork for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, SpainNetwork for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, SpainMultiprofessional Teaching Unit of Family and Community Care La Laguna-Tenerife Norte, Management of Primary Care of Tenerife, Santa Cruz de Tenerife, SpainDepartment of Psychiatry, Hospital Álvaro Cunqueiro, SERGAS, Vigo, SpainDepartment of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, SpainTranslational Neuroscience Research Group, Galicia Sur Health Research Institute (IIS-Galicia Sur), SERGAS-UVIGO, CIBERSAM, Vigo, SpainService of Mental Health, General Management of Healthcare Programs, The Canary Islands Health Service, Las Palmas, Gran Canaria, Spain0Department of Psychiatry, University Hospital of Gran Canaria Doctor Negrín, Las Palmas, The Canary Islands, SpainCanary Islands Health Research Institute Foundation (FIISC), Tenerife, SpainEvaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, SpainNetwork for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, SpainNetwork for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain1Health Services Research Unit, Foundation for the Promotion of Health and Biomedical Research of Valencia Region (FISABIO), Valencia, Spain2Department of Preventive Medicine and Public Health, University of La Laguna, Tenerife, Canary Islands, SpainCanary Islands Health Research Institute Foundation (FIISC), Tenerife, SpainEvaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, SpainNetwork for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Barcelona, Spain3Institute of Biomedical Technologies (ITB), University of La Laguna, Tenerife, Canary Islands, SpainAimTo assess the effectiveness of two interventions of knowledge transfer and behavior modification to improve medication adherence in patients with depressive disorders.MethodsAn open, multicenter, three-arm clinical trial with random allocation by cluster to usual care or to one of the two interventions. The intervention for psychiatrists (PsI) included an educational program based on a patient-centered care model. The intervention for patients and relatives (PtI) included a collaborative care program plus a reminder system that works using an already available medication reminder application. The primary outcome was patient adherence to antidepressant treatment assessed through the Sidorkiewicz Adherence Instrument. Secondary measures were depression severity, comorbid anxiety and health-related quality of life. Mixed regression models with repeated measures were used for data analysis.ResultsTen psychiatrists and 150 patients diagnosed with depressive disorder from eight Community Mental Health Units in the Canary Islands (Spain) were included. Compared with usual care, no differences in long-term adherence were observed in either group PsI or PtI. The PsI group had significantly improved depression symptoms (B = −0.39; 95%CI: −0.65, −0.12; p = 0.004) during the follow-up period. The PtI group presented improved depression symptoms (B = −0.63; 95%CI: −0.96, −0.30; p < 0.001) and mental quality of life (B = 0.08; 95%CI: 0.004, 0.15; p = 0.039) during the follow-up period.ConclusionThe assessed interventions to improve adherence in patients with depressive disorder were effective for depression symptoms and mental quality of life, even over the long term. However, no effect on antidepressant adherence was observed.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1320159/fulldepressiontreatment adherence and complianceantidepressive agentsSpainrandomized controlled trial |
| spellingShingle | Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Tasmania del Pino-Sedeño Himar González-Pacheco Himar González-Pacheco Himar González-Pacheco Beatriz González de León Beatriz González de León Pedro Serrano-Pérez Pedro Serrano-Pérez Pedro Serrano-Pérez Francisco Javier Acosta Artiles Francisco Javier Acosta Artiles Cristina Valcarcel-Nazco Cristina Valcarcel-Nazco Cristina Valcarcel-Nazco Isabel Hurtado-Navarro Isabel Hurtado-Navarro Cristobalina Rodríguez Álvarez María M. Trujillo-Martín María M. Trujillo-Martín María M. Trujillo-Martín María M. Trujillo-Martín on behalf of MAPDep Team Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial Frontiers in Public Health depression treatment adherence and compliance antidepressive agents Spain randomized controlled trial |
| title | Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial |
| title_full | Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial |
| title_fullStr | Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial |
| title_full_unstemmed | Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial |
| title_short | Effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders: a cluster randomized controlled trial |
| title_sort | effectiveness of interventions to improve adherence to antidepressant medication in patients with depressive disorders a cluster randomized controlled trial |
| topic | depression treatment adherence and compliance antidepressive agents Spain randomized controlled trial |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1320159/full |
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