A method that dramatically improves patient adherence to depression treatment

Abstract

This study focused on increasing patient adherence to a prescribed medical regimen for depression or depressive symptoms. The goal was to demonstrate that a depression flow sheet supported by physician instruction, patient education, and diligent follow-up could enable depressed patients to better adhere to treatment. The study documented reduction in depression severity over time. In addition to depression data, sample characteristics of comorbid disorders were obtained.

Methods: Patients tentatively diagnosed with depression were asked to complete a self-administered 9-item diagnostic survey (PHQ-9) to confirm the severity of depressive symptoms. Physicians in the practice then implemented a flow sheet to record pertinent data including comorbidities. All data were kept in patients' medical charts. A second PHQ-9 survey was completed by patients after at least 4 weeks. A total of 103 subjects was analyzed during 2003-2004. Subsequently, patient charts were systematically audited throughout the study period to record adherence, reasons for nonadherence (if any), PHQ-9 survey results, and comorbidities.

Results: Patient adherence improved to a significantly greater extent among patients in our study compared with existing national research data on depression.

Conclusion: Use of a flow sheet, coupled with patient education and diligent follow-up, dramatically improved the rate of medication adherence in patients who initially presented with depressive symptoms--with or without comorbidities. A clinician or small group can adapt the PHQ-9 materials with modest effort and positively impact the care of their patients, including adherence to medication regimens.