Table 1.
Literature review: adherence-enhancement programmes with positive effects, beginning with the most recent (n = 11)
| Intervention | Author (year) [country] | Study design | Types of medication | Population/sample characteristics | Measures of adherence outcomes | Main findings for changes in adherence and/or depression |
|---|---|---|---|---|---|---|
| Online care management messaging follow-up programme | Simon et al (2011)39 [USA] | RCT pilot study | ADM categories not reported | 208 patients starting ADM, recruited from clinics using the Epic Electronic Medical Record System Intervention group = 106 Usual care = 102 |
Prescription refill data assessing total days dispensed and receipt of second antidepressant, indicating medication switch or combination |
Adherence: intervention patients had higher rates of adherence after 3 months Symptom severity: lower SCL scores after 5 months Satisfaction with treatment: greater satisfaction with treatment |
| Improve health e-Health intervention (improve.eu.) e-Health service to support collaborative depression care | Meglic et al (2010)37 [Slovenia] | Pilot study | ADM categories not reported | Pilot of 46 patients enrolled by seven physicians Intervention group = 21 Usual care = 25 |
Self-report questionnaire |
Adherence: in the control group, 3 of 9 patients were adherent to ADMs compared with 10 of 12 in the intervention group Symptom severity: significant within-group reduction in BDI II score fromtime 0 to time 1 Patient perceptions of care: no significant differences in perception of care accessibility or quality |
| Psychosocial intervention Treatment Initiation and Participation programme (TIP) |
Sirey et al (2010)42 [USA] | RCT pilot study | ADM categories not reported | 70 patients from geriatric and mixed aged primary care site Intervention group = 33 Usual care = 37 |
Self-report (medication and non-medication treatment compliance data form) with chart verification |
Adherence: TIP patients significantly more adherent at 6, 12 and 24 weeks Depressive symptoms: greater crease in depressive symptoms |
| Primary care practice-based healthcare assistant case management programme | Gensichen et al(2009)38 [Germany] | Clustered RCT | ADM categories not reported | 626 patients in small primary care practices, stratified by urban and rural practices Intervention group = 310 Usual care = 316 |
Patient self-report modified Morisky Adherence Scale |
Adherence: increased treatment adherence Symptom severity: lower mean scores on PHQ 9 values for depression symptoms Patient assessments of care: more favourable |
| Depression treatment intervention to reduce negative beliefs about antidepressants | Edlund et al (2008)36 [USA] | RCT | ADM categories not reported | 395 primary care patients in VA healthcare system Intervention group = 177 Usual care = 218 |
Self-report and electronic record monitoring whether > 80% dosages taken in prior month |
Adherence: beliefs generally not associated with taking medication. Summary measure of beliefs did predict initiating and adhering to ADMs Clinical response: not associated with clinical response Beliefs about ADMs: few effects on beliefs and were not in expected direction |
| Telemedicine-based collaborative care model | Fortney et al (2007)28 [USA] | Randomised intervention trial | ADM categories not reported | 395 primary care patients with PHQ 9 depression severity scores, 12 followed for 12 months Intervention group = 117 Usual care = 218 |
Self-report and pharmacy data, 80% prescriptions taken as prescribed in previous month at 6 and 12 months |
Adherence: intervention patients more likely to be adherent at both 6 and 12 months Respond/remit: intervention patients more likely to respond by 6 months and remit by 12 months |
| Depression disease self-management programme | Aubert et al (2003)34 [USA] | Longitudinal cohort observational study | ADM categories not reported | Members with new or recurrent episode of depression Three groups: Intervention = 505 Control = 3744 (Minimal intervention = 1375) |
Pharmacy claims data where acute phase adherence was a minimum of 84 days on therapy in a 114-day period; continuation phase adherence was 180 days of therapy in 231-day period |
Adherence: significantly more likely to adhere during acute phase and continuation phase. Also more likely refill prescription on more timely basis Therapy continuation: more likely to continue psychotherapy after 7 months Satisfaction with programme: over 90% felt mailings helpful, 98.7% calls helped answer questions, 81.7% helped take medications as recommended |
| Pharmacist collaborative care model | Finley et al (2002)35 [USA] | Intervention trial | Start or maintenance dose of fluoxetine, paroxetine, or other antidepressant | Cohort of primary care providers asked to refer patients to staffmodel HMO immediately after starting ADM Intervention group = 91 Control group = 129 |
Computerised prescription refill data |
Adherence: intent to treat analysis showed adherence significantly higher in intervention group Primary care provider visits: greater decline of primary care provider visits for intervention patients |
| Mail-based physician and HMO member educational intervention | Hoffman et al (2003)40 [USA] | Randomised controlled prospective design | Drug categories: SSRIs, TCAs and atypical agents | 9564 patients from a large IPA-model HMO newly enrolled and 7021 physicians included with cohort Intervention arm = 4899 patients and 3474 physicians Control group = 4665 patients and 3547 physicians |
Medication possession relative to refill data as specified by HEDIS | Adherence: significantly greater adherence at 90 and 180 days |
| Biopsychosocial intervention on depression relapse and antidepressant adherence/primary care-based depression programme | Lin et al (2003)31 [USA] Ludman et al (2003)32 [USA] |
Randomised intervention trial | ADM categories not fully reported (fluoxetine used with some patients) | 386 enrolled primary care patients at high risk for depression relapse from four large primary care clinics of group health cooperative Intervention group = 194 Control group = 192 |
Self-report data correlated highly with automated pharmacy refill records |
Adherence: increased favourable attitudes to ADM treatment and confidence in managing ADM side-effects, which were found to be significant predictors of adherence to maintenance pharmacotherapy Self-efficacy/managing depression: increased confidence in managing side-effects, depressive symptom monitoring, checking for early warning signs, and ‘planful coping’ at 3, 6, 9 and 12 months |
| Innovative approach through monitoring HEDIS standards | Roberts et al (2002)41 [USA] | Quality improvement multiphase design | ADM categories not reported | Members of major HMO with potential valid depression diagnosis Confirmed cohort of 6045 patients No control group |
% who received continuous trial of ADMs for 84 days (12 weeks) and no more than a 30-day gap allowed | Adherence: within the first year ADM compliance rates improved by more than 10% |