Tips from Other Journals

Patient Education Intervention for Depression Treatment



FREE PREVIEW Log in or buy this issue to read the full article. AAFP members and paid subscribers get free access to all articles. Subscribe now.


FREE PREVIEW Subscribe or buy this issue. AAFP members and paid subscribers get free access to all articles.

Am Fam Physician. 2007 Mar 15;75(6):912-915.

Background: Approximately one out of five persons will have a major depressive disorder during his or her lifetime. Many classes of medications have been shown to be effective in treating this disorder, but studies suggest that it can take two to six months of treatment for maximal benefit. However, a significant number of patients stop taking their medications before this, which is associated with a greater risk of relapse.

Selective serotonin reuptake inhibitors have improved tolerability and a lower discontinuation rate compared with older antidepressants, but patient discontinuation still can be as high as 28 percent within the first three months. Additionally, only 30 percent of patients discuss stopping their antidepressant medications with their physicians, and 25 percent stop their medications but tell their physicians they are continuing to take them. Reasons for discontinuation are multifactorial and need to be addressed. Providing patient education to improve compliance with a patient's other treatment regimens is one such strategy. Bron and colleagues assessed a patient education intervention designed to improve compliance with treatment.

The Study: Patients 18 to 65 years of age who were taking sertraline (Zoloft) and enrolled in the patient education program for one year were included in the study. Knowing More, an educational program that provides patients with information about sertraline, primarily targets patients who have taken the medication for fewer than three months. Persons who were started on the same medication but not enrolled in the patient education program made up the control group and were matched for age, gender, start time, and various components of sertraline use.

The intervention consisted of 10 patient communications over nine months that were mailed and sent by e-mail. After treatment initiation, follow-up was conducted for seven months. Using time to discontinuation and days of therapy, patients in the Knowing More program and those in the control group were assessed for adherence to their treatment regimens.

Results: The study population included 1,462 patients in the intervention group and the matching control group. The time to discontinuation was greater in the patient education group compared with the control group. At the end of the study, a significantly greater number of patients in the education group continued to take their medication. The mean number of days on therapy was 122.5 for the intervention group compared with 97.7 for the control group.

Conclusion: This study demonstrates that early patient education intervention can improve patient compliance with antidepressant therapy, and that intervention can be performed by mail.

Source

Bron MS, et al. Improving adherence to sertraline treatment: the effectiveness of a patient education intervention. Prim Care Companion J Clin Psychiatry. October 2006;8:285–90.


Copyright © 2007 by the American Academy of Family Physicians.
This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact afpserv@aafp.org for copyright questions and/or permission requests.

Want to use this article elsewhere? Get Permissions


Article Tools

  • Print page
  • Share this page
  • AFP CME Quiz

Information From Industry

Navigate this Article