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Trust in Provider Improves Antidepressant Adherence in DM

Patients with diabetes who perceive lack of shared decision-making found less adherent in Rx strategy

Trust in Provider Improves Antidepressant Adherence in DM

FRIDAY, April 18, 2014 (HealthDay News) -- Patients with diabetes who lack trust and shared decision-making with their providers are less likely to be adherent to antidepressant therapy for depression, according to research published online April 5 in the Journal of General Internal Medicine.

Amy M. Bauer, M.D., of the University of Washington in Seattle, and colleagues conducted an observational cohort study involving 1,523 adults with type 2 diabetes who received a new prescription for antidepressant therapy. The authors assessed the association between the patient-provider relationship and adherence to antidepressant medication.

The researchers found that patients with diabetes who perceived a lack of shared decision-making with their providers were significantly more likely to never fill their antidepressant prescription (primary nonadherence; relative risk [RR], 2.42; P < 0.05), never refill their antidepressant prescription after the initial prescription was dispensed (early non-persistence; RR, 1.34: P < 0.01), and experience a longer period of time without medication during the 12 months after their initial prescription (difference in new prescription medication gap [NPMG] of 5 percent; P < 0.01). Less trust in the provider was significantly associated with early non-persistence (RR, 1.22 to 1.25) and greater NPMG (estimated differences of 5 to 8 percent).

"Patients' perceptions of their relationships with providers, including lack of shared decision-making or trust, demonstrated strong associations with antidepressant non-adherence," the authors write.

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