Patterns of early adherence to the antidepressant citalopram among older primary care patients: The prospect study

被引:29
作者
Bogner, Hillary R. [1 ]
Lin, Julia Y. [1 ]
Morales, Knashawn H. [1 ]
机构
[1] Univ Penn, Dept Family Med & Community Hlth, Philadelphia, PA 19104 USA
关键词
aged; primary health care; patient compliance; adherence; compliance interventions;
D O I
10.2190/DJH3-Y4R0-R3KG-JYCC
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: Our purpose was to determine the personal characteristics associated with different patterns of adherence to the antidepressant citalopram in a primary care trial of depression management. Method: The study sample consisted of 228 adults aged 60 years and older recruited from primary care settings and who participated in a depression intervention. The intervention consisted of services of trained care managers, who offered recommendations to physicians following a clinical algorithm and helped patients with treatment adherence. Adherence to the antidepressant citalopram was measured using pill counts. We employed the latent class model to classify patients according to the pattern of adherence to citalopram over time. We examined the association of sociodemographic characteristics, depression status, cognitive status, and medical comorbidity with the resulting classes of adherence. Results: The latent class model generated three classes of adherence: known to be adherent, unknown adherence, and known to be nonadherent. Participants who were white were more likely to be in the known to be adherent class than in the known to be nonadherent class (odds ratio (OR) = 10.38, 95% confidence interval (CI) [3.47, 31.12]). Married participants were less likely to be in the unknown adherence class than the known to be nonadherent class (OR = 0.28, 95% CI [0.09, 0.85]). No associations between age, gender, education level, depression status, cognitive status, or medical comorbidity and classes of adherence were found. Conclusions: We found stronger relationships between ethnicity and marital status with patterns of adherence to citalopram, than we did other personal characteristics. Identification of a subgroup of patients at particularly high risk of nonadherence is important for the development of adherence interventions.
引用
收藏
页码:103 / 119
页数:17
相关论文
共 55 条
[1]   Adherence to maintenance-phase antidepressant medication as a function of patient beliefs about medication [J].
Aikens, JE ;
Nease, DE ;
Nan, DP ;
Klinkman, MS ;
Schwenk, TL .
ANNALS OF FAMILY MEDICINE, 2005, 3 (01) :23-30
[2]   BAYESIAN-ANALYSIS OF MINIMUM AIC PROCEDURE [J].
AKAIKE, H .
ANNALS OF THE INSTITUTE OF STATISTICAL MATHEMATICS, 1978, 30 (01) :9-14
[3]  
Alexopoulos GS, 1996, ARCH GEN PSYCHIAT, V53, P305
[4]   Adherence to antidepressant medications in black and Latino elderly patients [J].
Ayalon, L ;
Areán, PA ;
Alvidrez, J .
AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 2005, 13 (07) :572-580
[5]   PATIENT ADHERENCE TO PRESCRIBED THERAPIES [J].
BECKER, MH .
MEDICAL CARE, 1985, 23 (05) :539-555
[6]   Reducing suicidal ideation and depressive symptoms in depressed older primary care patients - A randomized controlled trial [J].
Bruce, ML ;
Ten Have, TR ;
Reynolds, CF ;
Katz, II ;
Schulberg, HC ;
Mulsant, BH ;
Brown, GK ;
McAvay, GJ ;
Pearson, JL ;
Alexopoulos, GS .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 291 (09) :1081-1091
[7]   A NEW METHOD OF CLASSIFYING PROGNOSTIC CO-MORBIDITY IN LONGITUDINAL-STUDIES - DEVELOPMENT AND VALIDATION [J].
CHARLSON, ME ;
POMPEI, P ;
ALES, KL ;
MACKENZIE, CR .
JOURNAL OF CHRONIC DISEASES, 1987, 40 (05) :373-383
[8]   DETERMINANTS OF NONCOMPLIANCE WITH SHORT-TERM ANTIBIOTIC REGIMENS [J].
COCKBURN, J ;
GIBBERD, RW ;
REID, AL ;
SANSONFISHER, RW .
BRITISH MEDICAL JOURNAL, 1987, 295 (6602) :814-818
[9]  
COONS SJ, 1994, CLIN THER, V16, P110
[10]   The acceptability of treatment for depression among African-American, Hispanic, and white primary care patients [J].
Cooper, LA ;
Gonzales, JJ ;
Gallo, JJ ;
Rost, KM ;
Meredith, LS ;
Rubenstein, LV ;
Wang, NY ;
Ford, DE .
MEDICAL CARE, 2003, 41 (04) :479-489