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Doctor Reminders Don't Improve Patient Drug Adherence

Faxes to physicians failed to boost antidepressant use, study found

THURSDAY, March 16, 2006 (HealthDay News) -- Faxing "reminder" alerts to doctors when their patients fail to refill antidepressant prescriptions may not keep patients taking the drugs as needed, a new study suggests.

According to background information in the study, antidepressants are most effective when taken for at least six months. However, adherence rates are low, and managed-care organizations have tried different methods to improve compliance.

This Harvard University study assessed a program that used faxes to notify doctors when their patients were not adhering to their antidepressant drug therapy during the first six months of treatment. Doctors were sent faxes when patients did not refill their prescriptions for at least 10 days past the date their previous prescription ran out.

As reported in the March 13 issue of the Archives of Internal Medicine, researchers tracked nearly 6,400 patients who began taking antidepressants before the fax alert program and more than 6,700 patients who started taking the drugs after the start of the fax program.

After two years, the team observed no significant change in adherence rates: 18 percent of patients were adherent before the start of the fax program and 17 percent were adherent after the start of the program. The rate of non-adherent patients remained constant, at about 75 percent.

"Given the high rates of nonadherence to long-term drug therapy in general, and to the use of antidepressants in particular, inexpensive interventions to improve adherence are needed," the study authors wrote. "However, based on the results of this study, managed-care organizations should be cautious about using this form of faxed reminder system as a singular approach for physicians to improve patient medication adherence."

They noted that programs that involve personal contact between patients and pharmacists, nurses and depression-care managers may be more effective.

More information

The American Academy of Family Physicians has more about antidepressants.

SOURCE: JAMA/Archives journals, news release, March 13, 2006
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