Evaluation of Factors Influencing Antidepressant Medication Compliance in Outpatient Treatment of Depressive Disorders in Korea

Objective:Medication compliance is associated with the treatment outcomes. The reported consequences of non-compliance are chronification, poor psychosocial outcomes and increased suicide rates. We measured the drug compliance using medication event monitoring system (MEMS) and several compliance measures in the outpatients with depressive disorders. In addition, we tried to find out the relationship of antidepressant compliance with other clinical correlates including insight in depressive disorders.Method:This study was performed in Korea university medical center, Guro hospital. Outpatients diagnosed as having depressive disorders were enrolled. Monitoring was performed in 76 depressive patients who were taking the mono-antidepressant therapy during the at least 4-week evaluation period. 17 item Hamilton Rating Scale for Depression (HRSD), Multidimensional Scale of Perceived Social Support (MSPSS) and the mood disorders insight scale (MDIS) were investigated. Compliance was measured using MEMS, clinician rating scale of antidepressant compliance, pill count, and patient's self-report.Results:A total of 76 outpatients were enrolled in this study. As the severity of depression increases, patients tended to perceive poor social support from others in the correlation analysis. Level of depression by HRSD was significantly correlated with MDIS scores. Compliance rates for MEMS, pill count, clinician rating scale of compliance and self-report were 51.9%, 71.4%, 79.2% and 75.3% respectively. We did not find any statistical significance between compliance variables and other clinical scale scores (MDIS, HRSD, and MSPSS).Conclusion:More severely depressed patients have higher scores of insight in case of depression. However, increased perception of insight in depressive patients was not directly related with the increase in treatment compliance. Further investigation is needed to understand other factors affecting the drug compliance especially in depressive patients..