Non-Adherence to Antidepressant Treatment and Related Factors in a Region of Spain: A Population-Based Registry Study

• Published in: Pharmaceutics 2022-12, Vol.14 (12), p.2696
• Main Authors: Pedrosa-Naudín, M Aránzazu, Gutiérrez-Abejón, Eduardo, Herrera-Gómez, Francisco, Fernández-Lázaro, Diego, Álvarez, F Javier
• Format: Article
• Language: English
• Subjects: Antidepressants; anxiety; Beliefs, opinions and attitudes; Chronic illnesses; Demographic aspects; depression; Dosage and administration; Drug therapy; drug utilization; medication adherence; Mental disorders; Mentally ill; Patient compliance; polypharmacy; Population-based studies; Psychotropic drugs
• ISSN: 1999-4923; 1999-4923
• DOI: 10.3390/pharmaceutics14122696

Antidepressants are a commonly prescribed psychotropic medication, and their use has increased in recent years. Medication non-adherence in patients with mental disorders is associated with worse health outcomes. A population-based registry study to assess antidepressant non-adherence during 2021 has been carried out. An indirect method based on the medication possession ratio (MPR) has been utilized. Patients with a MPR under 80% were classified as non-adherent. A multivariate logistic regression to identify non-adherence predictors has been used, considering sociodemographic (age, sex, institutionalization and urbanicity) and health related variables (diagnostics, antidepressant class, multiple prescribers, and polypharmacy). In 2021, 10.6% of the Castile and Leon population used antidepressants. These patients were institutionalized (7.29%), living in urban areas (63.44%), polymedicated with multiple prescribers (57.07%), and using serotonin selective reuptake inhibitors (SSRIs) (54.77%), other antidepressants (46.82%) or tricyclic antidepressants (TCAs) (13.76%). Antidepressants were prescribed mainly for depression (36.73%) and anxiety (29.24%). Non-adherence to antidepressants was more frequent in men (20.56%) than in woman (19.59%) and decreased with increasing age (32% up to 17 years old vs. 13.76% over 80 years old). TCAs were associated with the highest prevalence of non-adherence (23.99%), followed by SSRIs (20.19%) and other antidepressants (18.5%). Predictors of non-adherence in patients on antidepressants were: living in urban areas, using TCAs, and pain occurrence. Non-adherence to antidepressants decreases with aging. Being female, institutionalization, being polymedicated and having depression/anxiety alongside another psychiatric diagnosis are protective factors against non-adherence. The MPR is a robust indicator for the clinician to identify non-adherent patients for monitoring, and adopt any necessary corrective actions.