Lu Yang, Arthur David, Hu Lili, Cheng Gen, An Fengrong, Li Zheng
Department of Respiratory and Critical Care Medicine, Beijing Chao Yang Hospital, Peking Union Medical College, Beijing, China.
School of Health, Charles Darwin University, Melbourne, Victoria, Australia.
Int J Ment Health Nurs. 2016 Feb;25(1):71-9. doi: 10.1111/inm.12181. Epub 2015 Dec 22.
Antidepressant non-adherence among people with depressive disorder is a major, ongoing public health issue, yet few studies have focused on older adults and their medication adherence. Although treatment adherence is determined by multiple factors, one of the important and modifiable predictors are patients' attitudes and beliefs about medication. We explored a sample of 135 older Chinese people with major depression, and the relationship between beliefs about antidepressants and medication adherence. Sociodemographic and illness variables were also examined. In all, high antidepressant adherence was reported in 37.8%, moderate adherence in 39.2%, and low adherence in 23%. Ordinal regression analysis showed perceived necessity (P < 0.01) and concern (P < 0.01) about antidepressants were significant influencing factors. Other variables with a positive association with higher adherence were lower average income (P < 0.05), fewer number of prior episodes of depression (P < 0.01), and comorbid anxiety (P < 0.05). The present study highlights low adherence in a sample of older depressed Chinese people, and highlights how beliefs about medication affect adherence. Therefore, more attention should be focused on non-adherence in older patients, and there is a need to establish accessible and systematic education programmes to correct misconceptions to improve their adherence.
抑郁症患者中抗抑郁药治疗依从性差是一个长期存在的重大公共卫生问题，但很少有研究关注老年人及其药物治疗依从性。尽管治疗依从性由多种因素决定，但重要且可改变的预测因素之一是患者对药物的态度和信念。我们对135名患有重度抑郁症的中国老年人样本进行了研究，探讨了他们对抗抑郁药的信念与药物治疗依从性之间的关系。同时还检查了社会人口统计学和疾病变量。总体而言，报告显示抗抑郁药高依从性的占37.8%，中度依从性的占39.2%，低依从性的占23%。有序回归分析表明，对抗抑郁药的感知必要性（P < 0.01）和担忧（P < 0.01）是显著的影响因素。与较高依从性呈正相关的其他变量包括较低的平均收入（P < 0.05）、较少的既往抑郁发作次数（P < 0.01）和共病焦虑（P < 0.05）。本研究凸显了中国老年抑郁症患者样本中的低依从性，并强调了对药物的信念如何影响依从性。因此，应更多关注老年患者的不依从问题，有必要建立易于获取且系统的教育项目来纠正误解，以提高他们的依从性。
