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
. 2024 Jan-Dec:15:21501319241286313.
doi: 10.1177/21501319241286313.

Patient Perceived Barriers and Enablers to Medication Adherence in the Treatment of Depression: A Qualitative Study

Yuki Meng  1 , Christopher Chiu  2 , Mamta Kapoor  1 , Shelly-Anne Li  1   2 , Navaldeep Kaur  1 , Patricia Marr  1   2 , Debbie Kwan  1   2 , Kori Leblanc  1   2 , Catherine Ji  1   2 , Christine Papoushek  1   2
Affiliations

Patient Perceived Barriers and Enablers to Medication Adherence in the Treatment of Depression: A Qualitative Study

Yuki Meng et al. J Prim Care Community Health. 2024 Jan-Dec.

Abstract

Background: Depression affects approximately 280 million individuals globally and it is a leading cause of disability. Despite effective medication options, 50% of patients prematurely discontinue antidepressants within 6 months. We sought to understand patients' perspectives regarding their needs and expectations related to antidepressants.

Objectives: To identify and describe enablers and barriers that influence adult patients' medication adherence in depression treatment and to explore patients' educational needs on initiating or continuing antidepressant therapy.

Methods: Qualitative descriptive study was conducted using individual, semi-structured interviews of adult patients with depression who were prescribed an antidepressant within 3 months of study recruitment at an urban primary care clinic in Toronto, Canada. Thirteen participants were interviewed. Interviews were recorded and transcribed verbatim for inductive thematic analysis.

Results: Six themes emerged: safety and effectiveness of antidepressant, understanding of depression and its management, medication administration, healthcare experiences in the treatment of depression, and social influences and relationships. Barriers to adherence included adverse effects of antidepressants, preference for non-pharmacological therapies, uncertainty about therapeutic effects, and social stigma. In contrast, enablers were positive responses from antidepressants, fear of relapse, reminder aids, established routine, and a trusting patient-provider relationship. Participants desired access to reliable, evidence-based, and personalized educational information delivered through verbal, written, and digital formats to support antidepressant adherence.

Conclusion: To overcome the identified barriers, educational strategies should involve both patients and their prescribers to identify patient-specific needs and treatment goals, engage in shared decision-making, and maintain consistent follow-up to support antidepressant adherence.

Keywords: antidepressant; barriers and enablers; depression; medication adherence; patient perspectives; primary care; qualitative methods.

PubMed Disclaimer

Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

References

    1. World Health Organization. Depressive disorder (depression). World Health Organization. Updated March 31, 2023. Accessed December 1, 2023. https://www.who.int/news-room/fact-sheets/detail/depression#:~:text=Depr...
    1. Government of Canada, Statistics Canada. Mental disorders and access to mental health care. Government of Canada, Statistics Canada. Updated September 22, 2023. Accessed December 1, 2023. https://www150.statcan.gc.ca/n1/pub/75-006-x/2023001/article/00011-eng.htm
    1. GBD 2019. Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-1222. doi:10.1016/s0140-6736(20)30925-9 - DOI - PMC - PubMed
    1. Smetanin P, Stiff D, Briante C, Adair C, Ahmad S, Khan M. The Life and Economic Impact of Major Mental Illnesses in Canada: 2011 to 2041. RiskAnalytica, on behalf of the Mental Health Commission of Canada 2011; 2011.
    1. Cipriani A, Furukawa TA, Salanti G, et al.. Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet. 2018;391(10128):1357-1366. doi:10.1016/s0140-6736(17)32802-7 - DOI - PMC - PubMed

Publication types

Substances

LinkOut - more resources