Concordance therapy: an intervention to help older people take antidepressants.
BACKGROUND
Older people often do not adhere fully to antidepressant medication. Compliance Therapy improves adherence with antipsychotic medication.


OBJECTIVE
To adapt Compliance Therapy for use in older depressed patients, to pilot this 'Concordance Therapy' for feasibility and acceptability and to gain preliminary indications of its efficacy.


METHODS
Randomised controlled trial (RCT).


METHODS
Psychiatric services for older people in North London and Essex.


METHODS
A total of 19 older depressed patients.


METHODS
10 patients received Concordance Therapy over 3-4 sessions.


METHODS
9 patients received treatment as usual.


METHODS
medication adherence at 1 month.


METHODS
medication adherence at 3 months; depression severity, beliefs about medication, quality of life at 1 and 3 months; patient feedback about the therapy.


RESULTS
The therapy was acceptable to patients. INTERVENTION patients were more likely to take antidepressants, had a higher quality of life, had less depressive symptomatology and were less likely to be cases of depression at 1 month. Beliefs around antidepressants at 1 month were more positive in the intervention group but this was not the case for medication in general.


CONCLUSIONS
As a pilot, patient numbers were small and the findings did not reach statistical significance. Three patients (1 intervention, 2 control) were in hospital and therefore offered medication at follow-up.


CONCLUSIONS
Concordance Therapy for older people prescribed antidepressants is acceptable and feasible and shows sufficient promise of efficacy to justify an adequately powered RCT.
Higgins
N
N
South London and Maudsley NHS Trust, Section of Community Psychiatry (PriSM), Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK. n.higgins@iop.kcl.ac.uk
Livingston
G
G
Katona
C
C
D000368:Aged; D000375:Aging / Q000523:psychology*; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D010349:Patient Compliance; D010353:Patient Education as Topic; D011788:Quality of Life
D000928:Antidepressive Agents