Despite the fact that depression is one of the leading causes of disability worldwide, and that antidepressant therapy is essential for positive patient outcomes, many patients remain non-adherent to their prescribed treatment plan.^1,2 To quantify the scale of non-adherence in depression:

• Almost half of outpatients who are prescribed an antidepressant discontinue treatment within the first month^2,3
• Up to 68% of patients with depression discontinue treatment within 3 months, depending on the medication prescribed²
• Less than a third of patients with depression receive and
  take their medication appropriately²

What’s causing this?

The reasons for this potential non-adherence differ between patients. However, a number of factors could be contributing to a patient’s non-compliance with therapy, including:²

• Treatment-related adverse events
• Unawareness of the importance of adhering to treatment, even if they feel better
• Cognitive dysfunction, including difficulties with memory and concentration
• Feelings of hopelessness
• Greater focus on relieving somatic symptoms
• Stigmas surrounding depression, particularly regarding weakness
• Feelings that treatment is not deserved
• Lack of reassurance
• Lack of continuity of care
• Complex treatment regimens
• Cost of treatment
• Dissatisfaction with treatment response
• Chronic illness
• Perceived lack of a friendly relationship with healthcare professional

How can you help?

Some practising healthcare professionals recommend that an optimal method to address potential adherence difficulties when treating patients with depression is through a collaborative approach to their care. Working together can help to reinforce a positive physician-patient relationship, and provide insights into the patient’s priorities for treatment outcomes. This, in turn, can provide motivation for the patient to comply with treatment, in pursuit of change that is both helpful and important to them.⁴

Additionally, the provision of education regarding the importance of compliance in antidepressant treatment can improve patient adherence to therapy. One randomised, controlled, prospective study found that the administration of a monthly, mail-based education programme about antidepressant medications had a positive influence on patients’ compliance with treatment.⁵

Even the introduction of simple and specific educational messages about antidepressant treatment and adherence into appointments have been shown to enhance compliance with therapy, at least in primary care settings.⁶ Above all, it is essential to emphasise the importance of continuing with treatment to patients with depression, even after improvement or cessation of symptoms.