Antidepressant Adherence in Diabetics Better with Provider Trust
Diabetics who perceive lack of shared decision-making found less adherent.
Patients with diabetes who lack trust and shared decision-making with their providers are less likely to be adherent to antidepressant therapy for depression, according to research published in the Journal of General Internal Medicine.
Amy M. Bauer, M.D., of the University of Washington in Seattle, and colleagues conducted an observational cohort study involving 1,523 adults with type 2 diabetes who received a new prescription for antidepressant therapy. The authors assessed the association between the patient-provider relationship and adherence to antidepressant medication.
The researchers found that patients with diabetes who perceived a lack of shared decision-making with their providers were significantly more likely to never fill their antidepressant prescription (primary nonadherence; relative risk [RR], 2.42; P < 0.05), never refill their antidepressant prescription after the initial prescription was dispensed (early non-persistence; RR, 1.34: P < 0.01), and experience a longer period of time without medication during the 12 months after their initial prescription (difference in new prescription medication gap [NPMG] of 5 percent; P < 0.01). Less trust in the provider was significantly associated with early non-persistence (RR, 1.22 to 1.25) and greater NPMG (estimated differences of 5 to 8 percent).
"Patients' perceptions of their relationships with providers, including lack of shared decision-making or trust, demonstrated strong associations with antidepressant non-adherence," the authors write.