Response, remission and relapse in relation to adherence in primary care treatment of depression: A 2-year outcome study
2006 (English)In: International Clinical Psychopharmacology, ISSN 0268-1315, Vol. 21, no 2, 117-124 p.Article in journal (Refereed) Published
Non-adherence to antidepressant drug treatment is common. In a recent study in depressed primary care patients, we reported a strong relationship between adherence and response after 6 months. With the use of a naturalistic design, the patients in that study were prospectively followed for 2 years. The purpose of the present study was to investigate the patients' long-term outcome and, in particular, to examine the impact of patients' treatment adherence on response, remission and relapse. Of the 1031 patients in the intent-to-treat (ITT) sample, 835 completed the study. After 2 years, the overall remission rate defined as a Montgomery-Åsberg Depression Rating Scale score of nine or less was 68% in the ITT sample analysed with the last observation carried forward (LOCF) technique, and 75% in observed cases. In total, 34% of the responders experienced at least one relapse. Response rates (LOCF) were significantly higher in adherent compared to non-adherent patients at week 24 [95% confidence interval (CI) = 21.4-32.1], year 1 (95% CI = 12.3-22.2) and year 2 (95% CI = 9.2-19.0). Remission rates (LOCF) were also significantly higher in the group of adherent patients at week 24 (95% CI = 9.6-21.5), year 1 (95% CI = 10.0-21.5) and year 2 (95% CI = 11.0-22.0). No relationship between adherence and relapse rate was observed, although the mean time from response to first sign of relapse was significantly longer in the adherent patients (95% CI = 9-97 days). In conclusion, this 2-year follow-up study showed superior long-term recovery in patients who were adherent to antidepressant medication compared to non-adherent patients. © 2006 Lippincott Williams & Wilkins.
Place, publisher, year, edition, pages
2006. Vol. 21, no 2, 117-124 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-32397DOI: 10.1097/01.yic.0000199452.16682.b8Local ID: 18298OAI: oai:DiVA.org:liu-32397DiVA: diva2:253219