improvement strategies may improve with low family income as compared with those rates of adherence to antidepres- sants: with middle and high income.38 Comorbid substance use, use of older gen- Improving provider-patient communication eration antidepressants, and living in lower in- can have a positive impact on rates of adher- come neighborhoods is associated with lower ence to antidepressants. Specifically, three key rates of adherence.41 messages increase the odds of being adherent Being treated by a non-psychiatric specialist to antidepressant treatment. These consist of as opposed to a primary care physician or psy- talking with patients about expectations with re- chiatrist is associated with higher odds of nonad- spect to change in mood and potential side ef- herence.42 fects, and letting patients know what to do if they Younger patient age is associated with have questions about the medication.43 greater rates of nonadherence.41 Implementing a telephone care management program for outpatients prescribed antidepres- Conversely, receiving mental health specialty sants by primary care physicians can help im- care in addition to being prescribed antidepres- prove adherence rates.44 sants is associated with higher rates of adher- However, a more recent study revealed that ence: this same type of model did not improve adher- Patients are significantly more likely to con- ence rates over usual care for patients pre- tinue antidepressant treatment past 30 days if scribed antidepressants by psychiatrists.45 they receive psychotherapy.41 Implementing a telemedicine model for pri- Receipt of mental health specialty care in mary care clinics that lack on-site psychiatrists addition to antidepressants is strongly associ- can improve adherence rates, especially in rural ated with adherence to an antidepressant regi- communities with limited access to psychia- men.40,41 trists.46
with low family income as compared with those with middle and high income.38 Comorbid substance use, use of older gen- eration antidepressants, and living in lower in- come neighborhoods is associated with lower rates of adherence.41 Being treated by a non-psychiatric specialist as opposed to a primary care physician or psy- chiatrist is associated with higher odds of nonad- herence.42 Younger patient age is associated with greater rates of nonadherence.41 Conversely, receiving mental health specialty care in addition to being prescribed antidepres- sants is associated with higher rates of adher- ence: Patients are significantly more likely to con- tinue antidepressant treatment past 30 days if they receive psychotherapy.41 Receipt of mental health specialty care in addition to antidepressants is strongly associ- ated with adherence to an antidepressant regi- men.40,41 improvement strategies may improve rates of adherence to antidepres- sants: Improving provider-patient communication can have a positive impact on rates of adher- ence to antidepressants. Specifically, three key messages increase the odds of being adherent to antidepressant treatment. These consist of talking with patients about expectations with re- spect to change in mood and potential side ef- fects, and letting patients know what to do if they have questions about the medication.43 Implementing a telephone care management program for outpatients prescribed antidepres- sants by primary care physicians can help im- prove adherence rates.44 However, a more recent study revealed that this same type of model did not improve adher- ence rates over usual care for patients pre- scribed antidepressants by psychiatrists.45 Implementing a telemedicine model for pri- mary care clinics that lack on-site psychiatrists can improve adherence rates, especially in rural communities with limited access to psychia- trists.46
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