Patients More Likely to Follow Psychiatrist's Orders on Antidepressants
> 7/16/2007 9:42:31 AM

The first stages of antidepressant treatment can be very difficult; patients are often ambivalent about using medication and may not see results for weeks. Dr. Kara Bambauer studied 11,878 patients in Harvard Pilgrim Health Care to explore what factors contribute to drug non-adherence in these crucial stages, gauged here by failure to refill first and sixth month prescriptions.

The study found a variety of factors that predict non-adherence. Doctors should pay careful attention to young patients and patients who used pain medication in the past. Doctors should also pay careful attention to themselves. The type of doctor can be as important as the type of patient. Non-adherence rates at six months for treatment initiated by non-psychiatry specialists, general practitioners, and psychiatrists were 62.2%, 52.7%, and 49.1% respectively. This suggests that while general practitioners have a wide enough skill-set to handle depression better than a random specialist, they do not have the expertise necessary to convince and monitor patients as well as psychiatrists.

The authors of this study suggest that treatment begun by non-psychiatrists should be augmented by those MDs who specialize in mental health treatment. While the researchers did not speculate as to why psychiatrists had higher rates of success in regards to adherence, it would make sense that clients who are also undergoing some form of therapy would be more fully prepared for the changes that they experience on the drugs. Psychiatrists also might make patients more comfortable discussing their experience, creating a situation wherein the client will open up about the process rather than discontinue using the medication. With half of patients failing to finish their drug program, adherence is as important as the effectiveness of the drug so every care must be taken to ensure that patients follow medical advice. Continuing medical education about adherence could provide primary care doctors and even other specialists with valuable information regarding antidepressants and mental health drugs.

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