N Higgins1, G Livingston, C Katona. 1. South London and Maudsley NHS Trust, Section of Community Psychiatry (PriSM), Health Services Research Department, Institute of Psychiatry, De Crespigny Park, London, SE5 8AF, UK. n.higgins@iop.kcl.ac.uk
Abstract
BACKGROUND:Older people often do not adhere fully to antidepressant medication. Compliance Therapy improves adherence with antipsychotic medication. OBJECTIVE: To adapt Compliance Therapy for use in older depressed patients, to pilot this 'Concordance Therapy' for feasibility and acceptability and to gain preliminary indications of its efficacy. METHODS: Randomised controlled trial (RCT). SETTING: Psychiatric services for older people in North London and Essex. PARTICIPANTS: A total of 19 older depressed patients. INTERVENTION: 10 patients receivedConcordance Therapy over 3-4 sessions. CONTROL: 9 patients received treatment as usual. MAIN OUTCOME MEASURE: medication adherence at 1 month. SECONDARY OUTCOME MEASURES: medication adherence at 3 months; depression severity, beliefs about medication, quality of life at 1 and 3 months; patient feedback about the therapy. RESULTS: The therapy was acceptable to patients. INTERVENTION patients were more likely to take antidepressants, had a higher quality of life, had less depressive symptomatology and were less likely to be cases of depression at 1 month. Beliefs around antidepressants at 1 month were more positive in the intervention group but this was not the case for medication in general. LIMITATIONS: As a pilot, patient numbers were small and the findings did not reach statistical significance. Three patients (1 intervention, 2 control) were in hospital and therefore offered medication at follow-up. CONCLUSION:Concordance Therapy for older people prescribed antidepressants is acceptable and feasible and shows sufficient promise of efficacy to justify an adequately powered RCT.
RCT Entities:
BACKGROUND: Older people often do not adhere fully to antidepressant medication. Compliance Therapy improves adherence with antipsychotic medication. OBJECTIVE: To adapt Compliance Therapy for use in older depressedpatients, to pilot this 'Concordance Therapy' for feasibility and acceptability and to gain preliminary indications of its efficacy. METHODS: Randomised controlled trial (RCT). SETTING: Psychiatric services for older people in North London and Essex. PARTICIPANTS: A total of 19 older depressedpatients. INTERVENTION: 10 patients received Concordance Therapy over 3-4 sessions. CONTROL: 9 patients received treatment as usual. MAIN OUTCOME MEASURE: medication adherence at 1 month. SECONDARY OUTCOME MEASURES: medication adherence at 3 months; depression severity, beliefs about medication, quality of life at 1 and 3 months; patient feedback about the therapy. RESULTS: The therapy was acceptable to patients. INTERVENTION patients were more likely to take antidepressants, had a higher quality of life, had less depressive symptomatology and were less likely to be cases of depression at 1 month. Beliefs around antidepressants at 1 month were more positive in the intervention group but this was not the case for medication in general. LIMITATIONS: As a pilot, patient numbers were small and the findings did not reach statistical significance. Three patients (1 intervention, 2 control) were in hospital and therefore offered medication at follow-up. CONCLUSION: Concordance Therapy for older people prescribed antidepressants is acceptable and feasible and shows sufficient promise of efficacy to justify an adequately powered RCT.
Authors: Rob Horne; Sarah C E Chapman; Rhian Parham; Nick Freemantle; Alastair Forbes; Vanessa Cooper Journal: PLoS One Date: 2013-12-02 Impact factor: 3.240
Authors: Tasmania Del Pino-Sedeño; Wenceslao Peñate; Carlos de Las Cuevas; Cristina Valcarcel-Nazco; Ascensión Fumero; Pedro Guillermo Serrano-Pérez; Francisco Javier Acosta Artiles; Vanesa Ramos García; Beatriz León Salas; Daniel Bejarano-Quisoboni; María M Trujillo-Martín Journal: Patient Prefer Adherence Date: 2019-02-22 Impact factor: 2.711