Adherence to escitalopram treatment in depression: a study of electronically compiled dosing histories in the 'Depression: the search for phenotypes' study.
Wessels, Alette M; Jin, Yuyan; Pollock, Bruce Get al.
2012 • In International Clinical Psychopharmacology, 27 (6), p. 291-7
Citalopram; Adult; Citalopram/therapeutic use; Depression/drug therapy; Depression/psychology; Female; Follow-Up Studies; Humans; Male; Medical Records Systems, Computerized/instrumentation; Medical Records Systems, Computerized/standards; Medication Adherence/psychology; Middle Aged; Monitoring, Ambulatory/instrumentation; Monitoring, Ambulatory/methods; Psychotherapy/methods; Psychotherapy/standards; Treatment Outcome; Young Adult; Phenotype; adherence; depression; MEMS; Psychiatry and Mental Health; Electronic monitoring; Persistence; Implementation
Abstract :
[en] Poor adherence to depression treatment is common. Understanding determinants of poor adherence to therapy is crucial to ensure optimal clinical outcomes. The aim of this study was to describe characteristics of dosing history in participants with depression receiving once daily escitalopram. Participants were randomly assigned to interpersonal psychotherapy (IPT) or pharmacotherapy. Participants assigned to IPT who did not evidence a response or remission had escitalopram added to their treatment. Adherence to pharmacotherapy was assessed using an electronically monitored pill cap (MEMS). Fifty-four participants on escitalopram alone and 32 on escitalopram+IPT were monitored. After 200 days, 71.7% of the participants in the escitalopram group and 54.8% of those in the escitalopram+IPT group were still engaged with the dosing regimen. Of those engaged in the dosing regimen, 17.9% (average over 210 days) of the participants did not take their medication (nonexecution). In 69% of the days participants took the correct dosage required. On average, participants had three drug holidays and the mean length of a holiday was 7 days per patient. No difference in adherence patterns was observed between patients receiving escitalopram alone vs. IPT+escitalopram. Early discontinuation of treatment and suboptimal daily execution of the prescribed regimen are the most common facets of poor adherence in this study population.
Disciplines :
Psychiatry
Author, co-author :
Wessels, Alette M; Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA. awessels@iupui.edu
Jin, Yuyan; Department of Pharmaceutical Sciences, School of Pharmacy, United States
Pollock, Bruce G; School of Medicine, United States ; Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
Frank, Ellen; School of Medicine, United States
Lange, Anne-Catherine ; Université de Liège - ULiège > Département de mathématique > Probabilités et statistique mathématique ; AARDEX Group Ltd., Sion, Switzerland
Vrijens, Bernard ; Université de Liège - ULiège > Département des sciences de la santé publique ; AARDEX Group Ltd., Sion, Switzerland
Fagiolini, Andrea; School of Medicine, United States
Kupfer, David J; School of Medicine, United States
Rucci, Paola; School of Medicine, United States
Kepple, Gail; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
Anderton, Joel; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
Buttenfield, Joan; Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, United States
Bies, Robert R; Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN 46202, United States ; Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
Adherence to escitalopram treatment in depression: a study of electronically compiled dosing histories in the 'Depression: the search for phenotypes' study.
Publication date :
November 2012
Journal title :
International Clinical Psychopharmacology
ISSN :
0268-1315
Publisher :
Ovid Technologies (Wolters Kluwer Health), England
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