Patient Preference and Adherence The effect of knowledge and expectations on adherence to and persistence with antidepressants
Patient Preference and Adherence The effect of knowledge and expectations on adherence to and persistence with antidepressants
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发表时间：
2016
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通讯作者：
S. Woodward;B. Bereznicki;J. Westbury;L. Bereznicki
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作者：
S. Woodward;B. Bereznicki;J. Westbury;L. Bereznicki
目的：抗抑郁药的依从性和持久性往往是次优的。然而，很少有人知道患者的知识和结果的期望可能会影响抗抑郁药的依从性和持久性。方法：在过去6个月内首次服用抗抑郁药治疗抑郁症的人被招募到Facebook上进行在线调查。知识，接受的教育，和最初的结果预期进行了分析与持久性和依从性的关联。结果：共分析了220份问卷。共有117名参与者服用抗抑郁药至少3个月;另外25名参与者在3个月后从未开始或停止服用抗抑郁药，而没有咨询医生。持久性和非持久性的参与者之间的期望和各种教育信息的差异被确定。接受“未经医生检查不要停止”的指导是持久性的重要独立预测因素（比值比[OR] = 5.9，95%置信区间[CI] = 1.4-24.5）。在调查时，82.7%的参与者正在服用抗抑郁药，77.9%的人坚持服用。依从性的重要独立预测因素是年龄较大的患者（OR = 1.1，95%CI = 1.0-1.2），知识（OR = 1.6，95%CI = 1.1-2.3），告知常见副作用（OR = 5.5，95% CI = 1.1-29.0），讨论了解决问题的方法（OR = 3.9，95% CI = 1.1-14.5）。结论：改善结果预期和特定的教育信息可能会增加依从性和持久性。更多的知识可以提高依从性。进一步的调查是必要的，以确定是否专注于这些简单的教育信息将改善患者谁开始抗抑郁药的结果。
Purpose: Adherence to and persistence with antidepressants are often suboptimal. However, little is known about how patient knowledge and outcome expectations may influence antidepressant adherence and persistence. Method: Individuals who had been prescribed their first antidepressant to treat depression in the preceding 6 months were recruited to an online survey via Facebook. Knowledge, education received, and initial outcome expectations were analyzed for associations with persistence and adherence. Results: Two hundred and twenty surveys were analyzed. A total of 117 participants had taken their antidepressant for at least 3 months; another 25 had never started or stopped after , 3 months without consulting their doctor. Differences in expectations and various educational messages among persistent and nonpersistent participants were identified. Having received the instruction “don’t stop it without checking with your doctor” was a significant independent predictor of persistence (odds ratio [OR] = 5.9, 95% confidence interval [CI] = 1.4–24.5). At the time of the survey, 82.7% of participants were taking an antidepressant and 77.9% were adherent. Significant independent predictors of adherence were a greater age (OR = 1.1, 95% CI = 1.0–1.2), knowledge (OR = 1.6, 95% CI = 1.1–2.3), being informed of common side effects (OR = 5.5, 95% CI = 1.1–29.0), and having discussed ways to solve problems (OR = 3.9, 95% CI = 1.1–14.5). Conclusion: Improving outcome expectations and particular educational messages may increase adherence and persistence. Greater knowledge may enhance adherence. Further investigation is warranted to determine whether a focus on these simple educational messages will improve outcomes in patients who commence an antidepressant.