Improving Antidepressant Adherence in Older Adults

描述（由申请人提供）：本提案是为K23指导的以患者为导向的研究科学家奖。申请人是一名临床心理学家，也是康奈尔大学老年情绪障碍干预研究中心的发展中研究者。该申请的目标是提供进一步的跨学科培训和研究机会，使申请人成为干预研究的独立研究者。申请人的职业目标是制定干预措施，以提高初级保健中抑郁症老年人对抗抑郁治疗的依从性。该应用程序的职业发展目标是学习：1）行为改变干预措施的理论基础; 2）晚年抑郁症干预措施的设计和评估; 3）老年人的态度和信仰的评估;和4）影响疾病治疗依从性的因素。该培训将提供知识和技能，以评估和解决有关以下方面的负面态度和信念：1）抑郁症和治疗效果的有用性，2）耻辱，以及3）治疗自我效能。这项研究将试点一个简短的，个性化的干预，以提高坚持SSRI抗抑郁药治疗的老年人由初级保健医生处方的有用性。该干预措施旨在通过解决阻碍老年抑郁症成年人坚持的消极态度和信念来提高坚持性。虽然干预不是减少抑郁症的疗法;但由于抑郁症本身会导致消极的态度和信念，干预的目标之一是缓冲抑郁症对依从性的影响。干预措施针对的是依从性障碍，如果被证明是有用的，将是一种手动和可行的方法，以减少在初级保健中看到的老年人晚年抑郁症治疗不足的个人和公共卫生成本。

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.