Duration and adherence of antidepressant treatment (2003 to 2007) based on prescription database.
BACKGROUND
Many patients discontinue antidepressant therapy long before the six-month minimum duration recommended for the treatment of major depression and many other diagnoses.


OBJECTIVE
To estimate the duration of antidepressant treatment and to analyse the following factors in relation to treatment adherence: age, sex, polypharmacy and type of drug.


METHODS
Retrospective cohort followed up for five years (2003-2007) based on prescription database.


METHODS
Users who had received at least one antidepressant prescription in 2003 and who had not received antidepressants during the previous 12 months.


METHODS
Age, sex, drug, polypharmacy, period of treatment, packs dispensed. Adequate adherence was defined as dispensation of medication during at least 80% of the treatment period, and compliance was defined as good when, in addition, the treatment lasted more than four months.


RESULTS
Of the 7525 patients selected, 56% abandoned medication during the first four months. Men were more likely to give up medication before time than women. Good compliance was recorded in 22% of patients and was twice as frequent in patients with high levels of polypharmacy than in those with low levels (31% vs. 15.3%). Patients receiving maprotiline, venlafaxine, mirtazapine, citalopram, clomipramine and fluoxetine presented the highest percentages of good compliance.


CONCLUSIONS
Only one out of five patients complied with treatment for over four months. Treatment periods were shorter in men. In chronic processes, patients receiving polypharmacy presented the best compliance.
Serna
M C
MC
Regional Primary Care Management Office, Catalan Institute of Health, University of Lleida, Lleida, Spain.
Cruz
I
I
Real
J
J
Gascó
E
E
Galván
L
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D016208:Databases, Factual; D003865:Major Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D019338:Polypharmacy; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D016903:Drug Monitoring
D000928:Antidepressive Agents