Improving Antidepressant Adherence in Older Adults

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DESCRIPTION (provided by applicant): This proposal is for a K23 Mentored Patient-Oriented Research Scientist Award. The applicant is a clinical psychologist and a developing investigator in the Cornell Intervention Research Center for Geriatric Mood Disorders. The goal of this application is to provide further interdisciplinary training and research opportunities to transition the applicant to become an independent investigator in interventions research. The career goal of the applicant is to develop interventions to improve adherence to antidepressant treatment among depressed older adults in primary care. The career development objectives of this application are to learn: 1) the theories underlying behavioral change interventions: 2) the design and evaluation of interventions in late-life depression; 3) assessment of older adults' attitudes and beliefs; and 4) factors that affect treatment adherence across illnesses. This training will provide the knowledge and skills to assess and to address negative attitudes and beliefs about: 1) depression and the usefulness of treatment efficacy, 2) stigma, and 3) treatment self-efficacy. The research proposed will pilot the usefulness of a brief, individualized intervention to improve adherence to SSRI antidepressant therapy by older adults prescribed by Primary Care Physicians. The intervention is designed to improve adherence by addressing the negative attitudes and beliefs that are obstacles to adherence for adults with late-life depression. Although the intervention is not a therapy to reduce depression; but because depression itself can contribute to negative attitudes and beliefs, one of the goals of the intervention is to buffer the effect of depression on adherence. The intervention targets obstacles to adherence and if proven useful, would be a manualized and feasible way to reduce the personal and public health costs of under treatment of late-life depression in older adults seen in primary care.