The association between side effects and adherence to antidepressants among primary care community-dwelling older adults

Abstract

Aims: To evaluate the association between adherence to antidepressants and self-reported side effects while considering their tolerability among primary care community-dwelling older adults.

Methods: This is a secondary analysis of data available for 137 individuals participating in the third wave of the Étude sur la Santé des Aînés – Services study (2015–2017) conducted among older adults aged 65 years and older. Adherence to antidepressants was assessed with the 4-item Medication Assessment Questionnaire. Side effects were also self-reported from a list of 20 potential side effects related to antidepressant use, while considering their tolerability (tolerable and non-tolerable) and were then grouped into seven categories specific to organ or function systems. Multilevel logistic regression analyses were carried out to assess the association between adherence and the presence of side effects accounting for participants nested within primary health clinics.

Results: In this study, 69.3% of participants were adherent to their antidepressants and 30.7% were non-adherent. Participants reporting sleep disturbance (OR = 0.58, 95% CI = 0.47–0.72), gastrointestinal system (OR = 0.64, 95% CI = 0.45–0.92), and nervous system (OR = 0.60, 95% CI = 0.48–0.78) related side effects were less likely to be adherent to their antidepressants. Participants reporting palpitations were more likely to adhere to antidepressants (OR = 2.20, 95% CI = 1.03–4.67). With regards to severity, participants reporting non-tolerable nervous system related side effects were less likely to be adherent (OR = 0.37, 95% CI = 0.26–0.53) and those reporting non-tolerable gastrointestinal system related side effects reported higher adherence to antidepressants (OR = 1.82, 95% CI = 1.08–3.08).

Conclusion: Adherence to antidepressants was associated with side effects, and more precisely with sleep disturbance, gastrointestinal and nervous systems side effects.

Keywords:

• Antidepressants
• side effects
• adherence
• seniors
• drug safety

Acknowledgements

The authors sincerely acknowledge the contribution of Dr. Djamal Berbiche, for preparing the dataset and the statistical support received.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

R Milan and H-M Vasiliadis formulated the research question. R Milan conducted the analyses, interpreted the results and drafted of the manuscript. H-M Vasiliadis edited and revised the manuscript.

Additional information

Funding

ESA-Services study is supported in part by the Canadian Institutes of Health Research (CIHR) operating grant # 201403 and by the Fonds de Recherche du Québec - Santé (FRQ-S) operating grant # 22251. H-M Vasiliadis is a senior scientist with the FRQ-S.