The association between race and gender, treatment attitudes, and antidepressant treatment adherence
The association between race and gender, treatment attitudes, and antidepressant treatment adherence
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DOI：
10.1002/gps.3984
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发表时间：
2014-02-01
影响因子：
4
通讯作者：
Kales, Helen C.
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文献类型：
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作者：
Burnett-Zeigler, Inger;Kim, H. Myra;Kales, Helen C.
目的：探讨治疗态度和信念与抗抑郁药物依从性的种族性别差异之间的关系。方法研究对象（n=186）为60岁的非裔美国人和白人受试者，诊断为临床显著的抑郁症，并有新的门诊初级保健推荐抗抑郁治疗。使用简短用药问卷评估抗抑郁药物依从性。态度和信念的评估使用患者对抑郁症护理的态度和评分，两个项目评估感知药物的重要性，以及接受心理帮助的污名量表的修改版本。结果非裔美国男性和女性对抗抑郁药物的关注程度明显高于白人女性，对治疗的了解程度明显低于白人女性。非裔美国男性对医疗服务提供者的负面态度明显高于非裔美国女性和白人女性。非裔美国女性比白人男性和女性更倾向于将抗抑郁药以外的药物视为最重要的药物。尽管在个人灵性方面发现了一些种族-性别差异，但在感知耻辱方面没有发现群体差异。在调整了关键基线变量的逻辑回归模型中，白人女性比非裔美国女性更坚持服用抗抑郁药（OR=3.05, 95% CI=1.06-8.81）。对抗抑郁药的关注较少，表明抗抑郁药是最重要的药物，这两者都与依从性显著相关。纳入这两个变量后，白人妇女和非裔美国妇女的依从性差异不再显著（OR=2.56, 95% CI=0.84-7.80）。结论：对抗抑郁药物的担忧和抗抑郁药物治疗的重要性与依从性有关，并有可能通过改善医患沟通、心理教育和治疗干预来改变。版权所有：John Wiley & Sons， Ltd。
ObjectivesWe examined the associations between treatment attitudes and beliefs with race-gender differences in antidepressant adherence.MethodsSubjects (n=186) were African-American and White subjects aged 60years, diagnosed with clinically significant depression, and had a new outpatient primary care recommendation for antidepressant treatment. Antidepressant adherence was assessed using the Brief Medication Questionnaire. Attitudes and beliefs were assessed using the Patients Attitudes Toward and Ratings of Care for Depression, two items rating perceived medication importance, and a modified version of the Stigma Scale for Receiving Psychological Help.ResultsAfrican-American men and women had significantly greater concerns about antidepressants and significantly less understanding about treatment than White women. African-American men had significantly more negative attitudes toward healthcare providers than African-American and White women. African-American women were more likely than White men and women to endorse a medication other than their antidepressant as most important. Whereas some race-gender differences were found in personal spirituality, no group differences were found in perceived stigma. In a logistic regression model adjusted for key baseline variables, White women were significantly more adherent to antidepressants than African-American women (OR=3.05, 95% CI=1.06-8.81). Fewer concerns about antidepressants and indicating the antidepressant as the most important medication were both significantly associated with adherence. After including either of these two variables, the adherence difference between White women and African-American women was no longer significant (OR=2.56, 95% CI=0.84-7.80).ConclusionsConcerns about antidepressants and the importance of antidepressant medication are associated with adherence and are potentially modifiable through improved patient-provider communication, psycho-education, and therapeutic interventions. Copyright (c) 2013 John Wiley & Sons, Ltd.