Racial differences in adherence to antidepressant treatment in later life

Helen C. Kales, Donald E. Nease, Jo Anne Sirey, Kara Zivin, Hyungjin Myra Kim, Janet Kavanagh, Shana Lynn, Claire Chiang, Harold W. Neighbors, Marcia Valenstein, Frederic C. Blow

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Objective: Although antidepressants are an effective treatment for later-life depression, older patients often choose not to initiate or to discontinue medication treatment prematurely. Although racial differences in depression treatment preferences have been reported, little is known about racial differences in antidepressant medication adherence among older patients. Design: Prospective, observational study comparing antidepressant adherence for older African American and white primary care patients. Participants: A total of 188 subjects age 60 and older, diagnosed with clinically significant depression with a new recommendation for antidepressant treatment by their primary care physician. Measurement: Study participants were assessed at study entry and at the 4-month follow-up (encompassing the acute treatment phase). Depression medication adherence was based on a well-validated self-report measure. Results: At the 4-month follow-up, 61.2% of subjects reported that they were adherent to their antidepressant medication. In unadjusted and two of the three adjusted analyses, African American subjects (n = 82) had significantly lower rates of 4-month antidepressant adherence than white subjects (n = 106). African American women had the lowest adherence rates (44.4%) followed by African American men (56.8%), white men (65.3%), and white women (73.7%). In logistic regression models controlling for demographic, illness, and functional status variables, significant differences persisted between African American women and white women in reported 4-month antidepressant adherence (OR: 3.58, 95% CI: 1.27-10.07, Wald χ2 = 2.42, df = 1, p <0.02). Conclusions: The results demonstrate racial and gender differences in antidepressant adherence in older adults. Depression treatment interventions for older adults should take into account the potential impact of race and gender on adherence to prescribed medications.

Original languageEnglish (US)
Pages (from-to)999-1009
Number of pages11
JournalAmerican Journal of Geriatric Psychiatry
Volume21
Issue number10
DOIs
StatePublished - Oct 2013
Externally publishedYes

Keywords

  • Depression care
  • Disparities
  • Treatment adherence

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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    Kales, H. C., Nease, D. E., Sirey, J. A., Zivin, K., Kim, H. M., Kavanagh, J., Lynn, S., Chiang, C., Neighbors, H. W., Valenstein, M., & Blow, F. C. (2013). Racial differences in adherence to antidepressant treatment in later life. American Journal of Geriatric Psychiatry, 21(10), 999-1009. https://doi.org/10.1016/j.jagp.2013.01.046