Dataset Information

Antidepressants in primary care: patients' experiences, perceptions, self-efficacy beliefs, and nonadherence.

ABSTRACT:

Purpose

Patient adherence to antidepressants is poor. However, this is rather unsurprising, given the equivocal efficacy, side effects, and practical problems of antidepressants. The aim of this study was to examine a wide array of patient experiences and perceptions regarding the efficacy, side effects, and practical problems of antidepressants, as well as their associations with nonadherence, and whether patients' perceived self-efficacy moderated these associations.

Patients and methods

Experiences and perceptions of 225 patients, recruited through community pharmacies, were efficiently assessed with the Tailored Medicine Inventory. Nonadherence was assessed through self-report and pharmacy refill data.

Results

Many patients were not convinced of the efficacy, thought the efficacy to be limited or did not believe antidepressants to prevent relapse, were worried about or had experienced one or more side effects, and/or had experienced one or more practical problems regarding information, intake, and packaging. Being convinced of efficacy was associated with lower intentional nonadherence (odds ratio [OR] 0.9, 95% confidence interval [CI] 0.8-0.96). A higher number of practical problems experienced was associated with increased unintentional nonadherence (OR 1.3, 95% CI 1.1-1.7). Higher perceived self-efficacy regarding taking antidepressants was associated with lower unintentional nonadherence (OR 0.7, 95% CI 0.5-0.9). Perceived self-efficacy did not moderate associations of patient experiences and perceptions with nonadherence.

Conclusion

Assessing a wide array of patients' experiences and perceptions regarding the efficacy, side effects, and practical problems of antidepressants contributes to better understanding of nonadherence to antidepressants. Guiding physician-patient conversations by patients' experiences and perceptions may reduce both unintentional and intentional nonadherence. Also, it may give rise to considerations of prudent discontinuation, eg, when patients are not convinced of the efficacy.

SUBMITTER: Wouters H

PROVIDER: S-EPMC3926453 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Publications

Antidepressants in primary care: patients' experiences, perceptions, self-efficacy beliefs, and nonadherence.

Wouters Hans H Bouvy Marcel L ML Van Geffen Erica Cg EC Gardarsdottir Helga H Stiggelbout Anne M AM Van Dijk Liset L

Patient preference and adherence 20140210

<h4>Purpose</h4>Patient adherence to antidepressants is poor. However, this is rather unsurprising, given the equivocal efficacy, side effects, and practical problems of antidepressants. The aim of this study was to examine a wide array of patient experiences and perceptions regarding the efficacy, side effects, and practical problems of antidepressants, as well as their associations with nonadherence, and whether patients' perceived self-efficacy moderated these associations.<h4>Patients and me ...[more]

PMID: 24550668

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Project description:BACKGROUND:Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control. METHODS:This was a cross-sectional study involving patients with type 2 diabetes mellitus from two public primary care clinics in Malaysia. Self-efficacy and self-care behaviour levels were measured using previously translated and validated DMSES and SDSCA questionnaires in Malay versions, respectively. Glycaemic control was measured using HbA1c. RESULTS: A total of 340 patients with type 2 diabetes mellitus were recruited. The total mean (±SD) of self-efficacy and self-care behaviour scores were 7.33 (±2.25) and 3.76 (±1.87), respectively. A positive relationship was found between self-efficacy and self-care behaviour (r 0.538, P <?0.001). Higher self-efficacy score was shown to be correlated with lower HbA1c (r -?0.41, P <?0.001). Multiple linear regression analysis demonstrated that higher self-efficacy scores (b -?0.398; 95% CI: -0.024, -?0.014; P <?0.001), shorter duration of diabetes (b 0.177; 95% CI: 0.002, 0.007; P <?0.001) and smaller waist circumference (b 0.135; 95% CI: 0.006, 0.035; P =?0.006), were significantly associated with good glycaemic control. CONCLUSION:This study demonstrated that higher self-efficacy was correlated with improved self-care behaviour and better glycaemic control. Findings of this study suggest the importance of including routine use of self-efficacy measures in the management of type 2 diabetes mellitus in primary care.

Dataset Information

Antidepressants in primary care: patients' experiences, perceptions, self-efficacy beliefs, and nonadherence.

Purpose

Patients and methods

Results

Conclusion

Publications

Antidepressants in primary care: patients' experiences, perceptions, self-efficacy beliefs, and nonadherence.

Similar Datasets

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