title: Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial.
abstract: OBJECTIVE
  To evaluate two different methods of improving adherence to antidepressant drugs.
  
  
  METHODS
  Factorial randomised controlled single blind trial of treatment leaflet, drug counselling, both, or treatment as usual.
  
  
  METHODS
  Primary care in Wessex
  
  
  METHODS
  250 patients starting treatment with tricyclic antidepressants.
  
  
  METHODS
  Adherence to drug treatment (by confidential self report and electronic monitor); depressive symptoms and health status.
  
  
  RESULTS
  66 (63%) patients continued with drugs to 12 weeks in the counselled group compared with 42 (39%) of those who did not receiving counselling (odds ratio 2.7, 95% confidence interval 1.6 to 4.8; number needed to treat=4). Treatment leaflets had no significant effect on adherence. No differences in depressive symptoms were found between treatment groups overall, although a significant improvement was found in patients with major depressive disorder receiving drug doses of at least 75 mg (depression score 4 (SD 3.7) counselling v 5.9 (SD 5.0) no counselling, P=0.038).
  
  
  CONCLUSIONS
  Counselling about drug treatment significantly improved adherence, but clinical benefit was seen only in patients with major depressive disorder receiving doses >/=75 mg. Further research is required to evaluate the effect of this approach in combination with appropriate targeting of treatment and advice about dosage.
authors.affiliation: Mental Health Group, University of Southampton, Royal South Hants Hospital, Southampton SO14 0YG. rcp@soton.ac.uk
authors.forename: R
authors.initials: R
authors.lastname: Peveler
authors.forename: C
authors.initials: C
authors.lastname: George
authors.forename: A L
authors.initials: AL
authors.lastname: Kinmonth
authors.forename: M
authors.initials: M
authors.lastname: Campbell
authors.forename: C
authors.initials: C
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents