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Comparison of Different Adherence Measures in Adolescent Outpatients with Depressive Disorder.
Patient Prefer Adherence. 2020; 14:1065-1072.PP

Abstract

Purpose

Adolescent depression can have a chronic course; hence, the importance of adherence to antidepressant medication for successful treatment outcomes is emphasized. This study aimed to examine different adherence measures and identify clinical factors that influence adherence in adolescent depression.

Patients and Methods

A prospective study was conducted for patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition from outpatient psychiatric settings at Korea University Medical Center, Guro Hospital. Patient demographics were obtained from a questionnaire, interview, and review of chart records. Adherence was assessed by four methods (Medication Event Monitoring System [MEMS], pill count, clinical rating scale, and patient's self-report). The Toronto Side Effect Scale was used to evaluate side effects, and specific depressive symptoms were assessed using the Hamilton Rating Scale for Depression and Childhood Depression Inventory-Korean version. The Multidimensional Scale of Perceived Social Support was administered to analyze social support, and the Parenting Stress Index-Short Form was used to evaluate parental stress levels. We used concordance correlation analysis to evaluate the relationship among the four adherence measures and the relationship between adherence level and clinical factors.

Results

Overall, the study enrolled 48 outpatients (mean age 16.33±1.93 years). The mean duration of illness was 1.27±2.17 years. Adherence rates for MEMS, clinician rating scale, pill count, and self-report after conversion to dichotomous measures were 67.5%, 48.9%, 60.0%, and 56.3%, respectively. Only the duration of illness remained significantly correlated with MEMS (r = 0.510, p =0.001).

Conclusion

Pill count exhibited a higher degree of agreement with MEMS adherence than the other two adherence measures, possibly indicating that pill count may be a considerably reliable measure of adherence. Furthermore, MEMS adherence was positively correlated with disease duration, suggesting that the longer the duration of illness, the higher the adherence.

Authors+Show Affiliations

Division of Child and Adolescent Psychiatry, Department of Psychiatry, Korea University Guro Hospital, Guro-gu, Seoul, Republic of Korea.Department of Psychiatry, Korea University Ansan Hospital, Ansan, Gyeonggi Province, Republic of Korea.Division of Child and Adolescent Psychiatry, Department of Psychiatry, Korea University Guro Hospital, Guro-gu, Seoul, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32606621

Citation

Mok, Young Eun, et al. "Comparison of Different Adherence Measures in Adolescent Outpatients With Depressive Disorder." Patient Preference and Adherence, vol. 14, 2020, pp. 1065-1072.
Mok YE, Lee JH, Lee MS. Comparison of Different Adherence Measures in Adolescent Outpatients with Depressive Disorder. Patient Prefer Adherence. 2020;14:1065-1072.
Mok, Y. E., Lee, J. H., & Lee, M. S. (2020). Comparison of Different Adherence Measures in Adolescent Outpatients with Depressive Disorder. Patient Preference and Adherence, 14, 1065-1072. https://doi.org/10.2147/PPA.S249728
Mok YE, Lee JH, Lee MS. Comparison of Different Adherence Measures in Adolescent Outpatients With Depressive Disorder. Patient Prefer Adherence. 2020;14:1065-1072. PubMed PMID: 32606621.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of Different Adherence Measures in Adolescent Outpatients with Depressive Disorder. AU - Mok,Young Eun, AU - Lee,Jong-Ha, AU - Lee,Moon-Soo, Y1 - 2020/06/24/ PY - 2020/02/14/received PY - 2020/05/26/accepted PY - 2020/7/2/entrez PY - 2020/7/2/pubmed PY - 2020/7/2/medline KW - clinician rating scale KW - duration of illness KW - medication event monitoring system KW - parental stress KW - pill count KW - self-report KW - symptom severity SP - 1065 EP - 1072 JF - Patient preference and adherence JO - Patient Prefer Adherence VL - 14 N2 - Purpose: Adolescent depression can have a chronic course; hence, the importance of adherence to antidepressant medication for successful treatment outcomes is emphasized. This study aimed to examine different adherence measures and identify clinical factors that influence adherence in adolescent depression. Patients and Methods: A prospective study was conducted for patients diagnosed with depressive disorder according to the Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition from outpatient psychiatric settings at Korea University Medical Center, Guro Hospital. Patient demographics were obtained from a questionnaire, interview, and review of chart records. Adherence was assessed by four methods (Medication Event Monitoring System [MEMS], pill count, clinical rating scale, and patient's self-report). The Toronto Side Effect Scale was used to evaluate side effects, and specific depressive symptoms were assessed using the Hamilton Rating Scale for Depression and Childhood Depression Inventory-Korean version. The Multidimensional Scale of Perceived Social Support was administered to analyze social support, and the Parenting Stress Index-Short Form was used to evaluate parental stress levels. We used concordance correlation analysis to evaluate the relationship among the four adherence measures and the relationship between adherence level and clinical factors. Results: Overall, the study enrolled 48 outpatients (mean age 16.33±1.93 years). The mean duration of illness was 1.27±2.17 years. Adherence rates for MEMS, clinician rating scale, pill count, and self-report after conversion to dichotomous measures were 67.5%, 48.9%, 60.0%, and 56.3%, respectively. Only the duration of illness remained significantly correlated with MEMS (r = 0.510, p =0.001). Conclusion: Pill count exhibited a higher degree of agreement with MEMS adherence than the other two adherence measures, possibly indicating that pill count may be a considerably reliable measure of adherence. Furthermore, MEMS adherence was positively correlated with disease duration, suggesting that the longer the duration of illness, the higher the adherence. SN - 1177-889X UR - https://www.unboundmedicine.com/medline/citation/32606621/Comparison_of_Different_Adherence_Measures_in_Adolescent_Outpatients_with_Depressive_Disorder L2 - https://dx.doi.org/10.2147/PPA.S249728 DB - PRIME DP - Unbound Medicine ER -
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