dosing on response during antidepressant treatment of depressed older adults (age
≥ 55 years) in primary care. They found patients in the study with good adherence
were more likely to respond, but that adequacy of dosage was not related to response.
This study was a secondary analysis of a study previously published.
- Sirey JA
- Banerjee S
- Marino P
- et al.
The original study was a randomized trial in which depressed older adults received
either usual care from a primary care physician (N = 116) or usual care plus the Treatment
Initiation and Participation Program (TIP) intervention (N = 115). The aim of the
invention was to improve adherence and to reduce depressive symptoms. Patient selection
was based on the Primary Care Physician (PCP)’s determination that the patient’s depression
required antidepressant treatment, but the diagnosis could include major depression
(43%), minor depression 27%, or “does not meet criteria” (29%). The study excluded
psychotic and bipolar depression. Adherence was assessed with the Brief Medication
Questionnaire, a self-report measure, and good adherence meant 80% of the doses were
taken. Depression severity was assessed with the 24-item Hamilton Depression Rating
Scale. Response was assessed by independent raters at 6, 12, and 24 weeks. In that
study the TIP intervention was associated with increased adherence at 6 weeks and
12 weeks, but TIP + usual care was not significantly more effective than usual care
in reducing depressive symptoms.
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Published online: May 19, 2020
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J. Craig Nelson is the sole contributor of the editorial.
© 2020 Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.