A RANDOMIZED-CONTROLLED TRIAL OF AN INTERVENTION TO IMPROVE ANTIDEPRESSANT ADHERENCE AMONG LATINOS WITH DEPRESSION

Authors

  • Alejandro Interian Ph.D.,

    Corresponding author
    1. Department of Psychiatry, UMDNJ—Robert Wood Johnson Medical School, Piscataway, New Jersey
    • VA New Jersey Health Care System, Mental Health & Behavioral Sciences, Lyons, New Jersey
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  • Roberto Lewis-Fernández M.D.,

    1. Columbia University and New York State Psychiatric Institute, New York, New York
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  • Michael A. Gara Ph.D.,

    1. Department of Psychiatry, UMDNJ—Robert Wood Johnson Medical School, Piscataway, New Jersey
    2. UMDNJ—University Behavioral Health Care, Piscataway, New Jersey
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  • Javier I. Escobar M.D.

    1. Department of Psychiatry, UMDNJ—Robert Wood Johnson Medical School, Piscataway, New Jersey
    2. Office of Global Health, UMDNJ—Robert Wood Johnson Medical School, New Brunswick, New Jersey
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Correspondence to: Alejandro Interian, VA New Jersey Health Care System, Mental Health and Behavioral Sciences (116A), 151 Knollcroft Road, Lyons, NJ 07939. E-mail: alejandro.interian@va.gov

Abstract

Background

Studies have consistently shown that Latinos with depression have lower adherence to antidepressant medication. Given that low adherence is associated with poorer response to treatment, this is a likely source of unequal care. The current study examined the efficacy of a motivational interviewing intervention for improving antidepressant adherence among Latinos with a depressive disorder.

Methods

Participants were 50 Latinos with a DSM-IV diagnosis of major depression or dysthymia who were receiving treatment at a community mental health center. Participants were recruited from July 2007 to December 2009 and were randomized to receive usual care (UC) or Motivational Enhancement Therapy for Antidepressants (META). META participants received three sessions of motivational interviewing as an enhancement to their usual care. Participants were assessed as baseline (time 1), 5 weeks (time 2), and 5 months (time 3). Antidepressant adherence was measured with the Medication Event Monitoring System (MEMS®) and changes in depression were measured with the Beck Depression Inventory-II (BDI-II).

Results

After adjusting for covariates, META participants showed significantly higher antidepressant adherence than UC participants at time 2 (72% versus 42%, respectively, p < .01) and time 3 (60% versus 34%, p < .01). The groups did not differ on mean BDI-II score across time. However, after adjusting for covariates, META participants were significantly more likely to show symptom remission on the BDI-II, compared to UC participants (OR = 7.0, p < .05).

Conclusions

This initial trial of META demonstrated feasibility and promising effects for improving antidepressant adherence. Some effects on depression were also observed.

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