Adherence to escitalopram treatment in depression: a study of electronically compiled dosing histories in the 'Depression: the search for phenotypes' study.
Adherence to escitalopram treatment in depression: a study of electronically compiled dosing histories in the 'Depression: the search for phenotypes' study.
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DOI：
10.1097/yic.0b013e3283597678
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发表时间：
2012-11
影响因子：
2.6
通讯作者：
Bies RR
中科院分区：
文献类型：
--
作者：
Wessels AM;Jin Y;Pollock BG;Frank E;Lange AC;Vrijens B;Fagiolini A;Kupfer DJ;Rucci P;Kepple G;Anderton J;Buttenfield J;Bies RR
对抑郁症治疗的依从性差是常见的。了解治疗依从性差的决定因素对于确保最佳临床结局至关重要。本研究的目的是描述每日一次接受艾司西酞普兰治疗的抑郁症受试者的给药史特征。参与者被随机分配到人际心理治疗（IPT）或药物治疗。分配至IPT组的受试者如果没有出现应答或缓解，则在其治疗中添加艾司西酞普兰。使用电子监测药丸帽（MEMS）评估药物治疗的依从性。对54名单独使用艾司西酞普兰的参与者和32名使用艾司西酞普兰+ IPT的参与者进行了监测。200天后，艾司西酞普兰组71.7%的受试者和艾司西酞普兰+ IPT组54.8%的受试者仍在接受给药方案。在参与给药方案的人中，17.9%（平均超过210天）的参与者没有服用药物（未执行）。在69%的日子里，参与者服用了正确的剂量。平均而言，参与者有三个药物假期，平均假期长度为7天。在接受艾司西酞普兰单药治疗与接受IPT+艾司西酞普兰治疗的患者之间，未观察到依从性模式存在差异。在本研究人群中，早期停止治疗和每日执行处方方案不理想是依从性差的最常见方面。
Poor adherence to depression treatment is common. Understanding determinants of poor adherence to therapy is crucial to ensure optimal clinical outcomes. The aim of this study was to describe characteristics of dosing history in participants with depression receiving once daily escitalopram. Participants were randomly assigned to interpersonal psychotherapy (IPT) or pharmacotherapy. Participants assigned to IPT who did not evidence a response or remission had escitalopram added to their treatment. Adherence to pharmacotherapy was assessed using an electronically monitored pill cap (MEMS). Fifty-four participants on escitalopram alone and 32 on escitalopram + IPT were monitored. After 200 days, 71.7% of the participants in the escitalopram group and 54.8% of those in the escitalopram + IPT group were still engaged with the dosing regimen. Of those engaged in the dosing regimen, 17.9% (average over 210 days) of the participants did not take their medication (nonexecution). In 69% of the days participants took the correct dosage required. On average, participants had three drug holidays and the mean length of a holiday was 7 days per patient. No difference in adherence patterns was observed between patients receiving escitalopram alone vs. IPT+ escitalopram. Early discontinuation of treatment and suboptimal daily execution of the prescribed regimen are the most common facets of poor adherence in this study population.