Amy M. Bauer|Dean Schillinger|Melissa M. Parker|Wayne Katon|Nancy J. Adler|Alyce S. Adams|Howard H. Moffet|Andrew J. Karter
Health Literacy and Antidepressant Medication Adherence Among Adults with Diabetes: The Diabetes Study of Northern California (DISTANCE)
University of Washington|San Francisco General Hospital|Kaiser Permanente|University of Washington|University of California, San Francisco|Kaiser Permanente|Kaiser Permanente|Kaiser Permanente
previous studies reported health literacy limitations associated poorer disease control chronic conditions evaluated potential associations medication adherence determine whether health literacy limitations associated poorer antidepressant medication adherence observational new prescription cohort followup study adults type 2 diabetes completed survey 2006 received new antidepressant prescription 20062010 n 1366 kaiser permanente northern california validated threeitem selfreport scale measured health literacy discrete indices adherence based pharmacy dispensing data according validated methods primary nonadherence medication never dispensed early nonpersistence dispensed never refilled nonpersistence 180 365 days new prescription medication gap npmg proportion time person without medication 12 months prescription date seventytwo percent patients classified health literacy limitations adjusting sociodemographic clinical covariates patients health literacy limitations significantly poorer adherence compared patients limitations whether measured early nonpersistence 46 versus 38 p 005 nonpersistence 180 days 55 versus 46 p 005 npmg 41 versus 36 p 001 significant associations primary adherence nonpersistence 365 days poorer antidepressant adherence among adults diabetes health literacy limitations may jeopardize continuation maintenance phases depression pharmacotherapy findings underscore importance national efforts address health literacy simplify health communications regarding treatment options improve public understanding depression treatment monitor antidepressant adherence