Effect of antidepressant drug counselling and information leaflets on adherence to drug treatment in primary care: randomised controlled trial. Issue 7210 (4th September 1999)

• Record Type: Journal Article
• Authors: Peveler, Robert; George, Charles; Kinmonth, Ann-Louise; Campbell, Michael; Thompson, Chris
• Is Part Of: BMJ. Volume 319:Issue 7210(1999)
• Page Start: 612
• Page End: 615
• Publication Date: 1999-09-04
• Subjects: Medicine -- Periodicals; Medicine -- Periodicals; Medicine; Periodicals; 610
• DOI: 10.1136/bmj.319.7210.612
• Languages: English
• ISSNs: 0007-1447

Abstract

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.