Medication use and nonadherence to psychoactive medication for mental health problems by community-living Canadian seniors with depression.
OBJECTIVE
To determine the relation between level of depression and psychoactive medication use and nonadherence in Canadian seniors, given that late-life depression is a common, serious mental health problem in Canada.


METHODS
Canadian Community Health Survey-Mental Health and Well-Being respondents aged 65 years and older (n = 7,736) comprised the study sample. Using the Composite International Diagnostic Interview to assess depressive symptoms, we created 4 depression levels to capture a spectrum of depressive disorders and (or) symptoms: major depression, comorbid major depression, depressive symptoms, and no depressive symptoms. Psychoactive medications assessed included sleep aids, anxiolytics, and mood stabilizers and (or) antidepressants (AD). Nonadherence was defined as either not taking medication as recommended or taking medication at a lower dosage than prescribed.


RESULTS
In total, 22.5% of respondents took psychoactive medication for a mental health problem in the previous 12 months. Psychoactive medication use was 46.8% for major depression, 43.1% for comorbid major depression, 34.0% for depressive symptoms, and 17.6% for no depressive symptoms. Rates of psychoactive medication use ranged from 46.5% of those with major depression, to 17.6% of those with no depressive symptoms. Overall, the rate of nonadherence to psychoactive medication was 31%; rates were highest among those with depressive symptoms (37.4%) and lowest among those with no depressive symptoms (27.4%). All 3 depressive categories were associated with greater odds of use and nonadherence.


CONCLUSIONS
All 3 depression categories were associated with increased use of and nonadherence to psychoactive medication; however, rates of AD and (or) mood stabilizer use for clinically significant depression were low.
Sewitch
Maida J
MJ
Department of Medicine, McGill University, Montreal, Quebec. maida.sewitch@mcgill.ca
Cole
Martin
M
McCusker
Jane
J
Ciampi
Antonio
A
Dyachenko
Alina
A
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002170:Canada / Q000453:epidemiology; D003156:Community Mental Health Services / Q000706:statistics & numerical data*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D016312:Treatment Refusal / Q000706:statistics & numerical data*
D000928:Antidepressive Agents; D011619:Psychotropic Drugs