Concordance therapy and medication adherence

和谐疗法与用药依从性 在初级保健环境中提高抗抑郁药物依从性的有效、低成本和 需要的是容易传播的信息。要检查这种干预措施的效用，需要考虑几个因素 请注意。首先，患者个体信念的差异可能会显著影响抗抑郁药物的依从性。 而且很可能需要个性化的关注。依从性可能有所不同，这取决于药物是否 急用的或用于继续治疗的此外，遵守干预可能需要有所不同 这取决于患者是在接受急性治疗还是在继续治疗。 此外，抑郁症和抑郁症在初级保健患者中也很常见。 可能会对坚持药物治疗方案产生不利影响。事实上，抑郁症状一直是 与几种慢性病治疗依从性不足有关，包括糖尿病、冠心病 动脉疾病、哮喘和高血压。 我们建议评估单一通道依从性干预的有效性(一致性 治疗)，由初级保健护士在种族多样化的初级保健患者样本中提供 单相抑郁和合并糖尿病或高血压。我们还将评估是否 抗抑郁药物治疗依从性的改善与口服依从性的改善有关 糖尿病或高血压的药物治疗方案。干预措施的唯一目标将是解决 急性抑郁症治疗中明确和具体的坚持障碍，以及具体的障碍 在持续抑郁治疗期间坚持治疗。具体来说，我们计划：1评估效果 和谐疗法改善单相抑郁患者抗抑郁药物依从性的研究 抑郁症和糖尿病或高血压的共病；以及2)评估 抗抑郁药物依从性：受试者是否坚持口服糖尿病或 高血压。

Concordance Therapy and Medication Adherence Interventions to improve antidepressant adherence in primary care settings that are effective, low-cost and easily disseminated are needed. To examine the utility of such interventions, several considerations require attention. First, differences in individual patient beliefs may significantly influence antidepressant adherence and will likely require individualized attention. Adherence may differ depending on whether the medication is being used acutely or in continuation treatment. Moreover, the adherence intervention may need to differ depending on whether the patient is in acute or continuation treatment. In addition, medical comorbidity is common among depressed primary care patients, and depression may have an adverse impact on adherence to medical regimens. In fact, depressive symptoms have been linked to inadequate treatment adherence in several chronic diseases, including diabetes mellitus, coronary artery disease, asthma, and hypertension. We propose to evaluate the effectiveness of a single modality adherence intervention (Concordance Therapy), delivered by primary care nurses, in a racially diverse sample of primary care patients with unipolar depression and comorbid diabetes mellitus or hypertension. We will also evaluate whether improvement in adherence to antidepressant treatment is associated with improvement in adherence to oral medication regimen for diabetes or hypertension. The intervention will be uniquely targeted to address identified and specific barriers to adherence in acute depression treatment, as well as specific impediments to adherence during continuation depression treatment. Specifically we plan to: 1 evaluate the effectiveness of Concordance Therapy to improve antidepressant adherence in primary care patients with unipolar depression and comorbid diabetes mellitus, or hypertension; and 2) To evaluate the impact of changes in antidepressant adherence on participants' adherence to oral medication regimen for diabetes or hypertension.