Antidepressant Adherence Among Hispanics: Patients in an Integrated Health Care Model

Abstract

Purpose

We report on antidepressant (AD) adherence among Hispanics seeking mental health services in a community primary care clinic in Texas as an ancillary outcome from a National Institutes of Health-funded study that collected data on Hispanic AD adherence over a period of two years (February 2016–February 2018). Adherence to AD medications was measured throughout the year-long trial and compared across various demographic characteristics. Since Hispanic individuals often experience stigma and cultural barriers related to AD treatment, we sought to understand what factors may increase the likelihood of non-adherence in this population.

Patients and Methods

This study focused on 69 patients who were prescribed AD medications while receiving treatment through an integrated health care model. Adherence was measured with the Patient Adherence Questionnaire, a validated 2-item questionnaire that asks patients about their medication use (missed medications or dosage changes) over the past week. We looked at patient adherence at two key time points (4-weeks and 13-weeks) and utilized logistic regression to identify factors that may increase or decrease the likelihood of adherence in Hispanic patients at a community primary care clinic.

Results

Non-adherence to AD medication was 49.3% at 4-weeks and 57% at 13-weeks post-treatment initiation. Logistic regression analyses revealed that age was the only significant predictor of AD non-adherence. As age increased, the likelihood of adherence increased by 12.2% at 13-weeks post-treatment initiation and by 11.1% at 4-weeks post-treatment initiation.

Conclusion

The likelihood of Hispanic patients to adhere to AD therapy increased with the age of the patient. Since primary care is the most likely place to be prescribed an AD for Hispanic patients, further research to better understand adherence is essential. Integrated health care interventions designed to help identify, reduce, or eliminate barriers to adherence and improve cultural understanding may help address issues of non-adherence in primary care settings.

Keywords:

• medication
• primary care
• mental health
• antidepressant adherence
• social work

Abbreviations

AD, antidepressant; PTSD, post-traumatic stress disorder; PHQ-9, Patient Health Questionnaire; GAD-7, Generalized Anxiety Disorder-7; PCL-C, post-traumatic stress disorder checklist; LSAS, Latino Scale for Antidepressant Stigma; PAQ, Patient Adherence Questionnaire.

Data Sharing Statement

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethics Approval and Informed Consent

The study protocol was reviewed and approved by the Institutional Review Board (IRB) of the University of Texas at Arlington (IRB reference number 2015-0839). All patients provided written informed consent prior to participation. Consent included the publication of their anonymized responses. This study complies with the Declaration of Helsinki.

Disclosure

Prof. Dr. Katherine Sanchez reports grants from National Institutes of Health, during the conduct of the study. The authors declare that they have no competing interests.

The abstract of this paper was presented at the Society for Social Work and Research Conference as a poster presentation with interim findings. The poster’s abstract was published in the conference’s website at https://sswr.confex.com/sswr/2022/webprogram/Paper46368.html.

Additional information

Funding

This project was funded by a grant from the National Institutes of Health (NIH) National Institute on Minority Health and Health Disparities (NIMHD, 1R15MD010220-01). The REDCap research database used for data collection was supported by the National Center for Advancing Translational Sciences (NCATS) of the NIH under award number UL1TR001105 via consortium partner UT Southwestern Center for Translational Medicine Service Package Grant (Number: SPG2016 – 017). The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.