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BMJ. 1999 Sep 4;319(7210):612-5.

Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial.

Author information

  • 1Mental Health Group, University of Southampton, Royal South Hants Hospital, Southampton SO14 0YG. rcp@soton.ac.uk

Abstract

OBJECTIVES:

To evaluate two different methods of improving adherence to antidepressant drugs.

DESIGN:

Factorial randomised controlled single blind trial of treatment leaflet, drug counselling, both, or treatment as usual.

SETTING:

Primary care in Wessex

PARTICIPANTS:

250 patients starting treatment with tricyclic antidepressants.

MAIN OUTCOME MEASURES:

Adherence to drug treatment (by confidential self report and electronic monitor); depressive symptoms and health status.

RESULTS:

66 (63%) patients continued with drugs to 12 weeks in the counselled group compared with 42 (39%) of those who did not receiving counselling (odds ratio 2.7, 95% confidence interval 1.6 to 4.8; number needed to treat=4). Treatment leaflets had no significant effect on adherence. No differences in depressive symptoms were found between treatment groups overall, although a significant improvement was found in patients with major depressive disorder receiving drug doses of at least 75 mg (depression score 4 (SD 3.7) counselling v 5.9 (SD 5.0) no counselling, P=0.038).

CONCLUSIONS:

Counselling about drug treatment significantly improved adherence, but clinical benefit was seen only in patients with major depressive disorder receiving doses >/=75 mg. Further research is required to evaluate the effect of this approach in combination with appropriate targeting of treatment and advice about dosage.

Comment in

PMID:
10473477
[PubMed - indexed for MEDLINE]
PMCID:
PMC28214
Free PMC Article

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