Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct 31:10:2209-2215.
doi: 10.2147/PPA.S109941. eCollection 2016.

Time to lack of persistence with pharmacological treatment among patients with current depressive episodes: a natural study with 1-year follow-up

Kanglai Li  1 , Qinling Wei  2 , Guanying Li  2 , Xiangjun He  2 , Yingtao Liao  2 , Zhaoyu Gan  2
Affiliations

Time to lack of persistence with pharmacological treatment among patients with current depressive episodes: a natural study with 1-year follow-up

Kanglai Li et al. Patient Prefer Adherence. .

Abstract

Introduction: Medication nonadherence remains a big challenge for depressive patients. This study aims to assess and compare the medication persistence between unipolar depression (UD) and bipolar depression (BD).

Methods: A total of 146 UD and 187 BD patients were recruited at their first index prescription. Time to lack of persistence with pharmacological treatment (defined as a gap of at least 60 days without taking any medication) was calculated, and clinical characteristics were collected. Final diagnosis was made at the end of 1-year follow-up.

Results: A total of 101 (69.2%) UD and 126 (67.4%) BD patients discontinued the treatment, with a median duration of 36 days and 27 days, respectively. No significant difference was found between UD and BD in terms of time to lack of persistence with pharmacological treatment. The highest discontinuation rate (>40%) occurred in the first 3 months for both groups of patients. For UD patients, those with a higher risk of suicide (odds ratio [OR] =0.696, P=0.035) or comorbidity of any anxiety disorder (OR =0.159, P<0.001) were less likely to prematurely drop out (drop out within the first 3 months), while those with onset in the summer (OR =4.702, P=0.049) or autumn (OR =7.690, P=0.012) were more likely to prematurely drop out than those with onset in the spring (OR =0.159, P<0.001). For BD patients, being female (OR =2.250, P=0.012) and having a history of spontaneous remission or switch to hypomania (OR =2.470, P=0.004) were risk factors for premature drop out, while hospitalization (OR =0.304, P=0.023) and misdiagnosis as UD (OR =0.283, P<0.001) at the first index prescription were protective factors.

Limitation: Conservative definition of nonadherence, low representativeness of sample.

Conclusion: Treatment discontinuation was frequently seen in patients with UD or BD, especially in the first 3 months of treatment. In spite of the similar pattern of medication persistence, UD and BD differ from each other in predictors of premature drop out.

Keywords: bipolar depression; medication adherence; unipolar depression.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The Kaplan–Meier survival curves of the time to lack of persistence with treatment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Hyler SE. APA online CME practice guideline for the treatment of patients with major depressive disorder. J Psychiatr Pract. 2002;8(5):315–319. - PubMed
    1. Yatham LN, Kennedy SH, Parikh SV, et al. Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: update 2013. Bipolar Disord. 2013;15(1):1–44. - PubMed
    1. Conti V, Lora A, Cipriani A, Fortino I, Merlino L, Barbui C. Persistence with pharmacological treatment in the specialist mental healthcare of patients with severe mental disorders. Eur J Clin Pharmacol. 2012;68(12):1647–1655. - PubMed
    1. Tanno S, Ohhira M, Tsuchiya Y, Takeuchi T, Tanno S, Okumura T. Frequent early discontinuation of SSRI prescribed by primary care physicians in young males in Japan. Intern Med. 2009;48(15):1263–1266. - PubMed
    1. Shigemura J, Ogawa T, Yoshino A, Sato Y, Nomura S. Predictors of antidepressant adherence: results of a Japanese Internet-based survey. Psychiatry Clin Neurosci. 2010;64(2):179–186. - PubMed

LinkOut - more resources