Document Detail


A comparison of various methods of measuring antidepressant medication adherence among children and adolescents with major depressive disorder in a 12-week open trial of fluoxetine.
MedLine Citation:
PMID:  20973714     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: In this study, we examined antidepressant (fluoxetine) medication adherence in children and adolescents with major depressive disorder (MDD). Using electronic monitoring (EM) as the "reference standard," we compared various methods of measuring antidepressant medication adherence (including EM, pill counts, and medication diaries) among children and adolescents with MDD and examined the relationship between EM medication adherence and depression severity across time. We then suggested recommendations for clinical researchers and practicing clinicians regarding medication adherence assessment.
METHOD: Thirty-one child and adolescent outpatients with MDD who enrolled in a 12-week open trial of fluoxetine had their antidepressant medication adherence assessed at each visit, using EM, pill counts, and parent and patient medication diaries. Depression severity was assessed by the Children's Depression Rating Scales-Revised at each visit.
RESULTS: Twelve-week least squares mean estimates of medication adherence for the entire sample was high, regardless of the adherence assessment method, although the overall adherence among the four methods (EM, pill, parent diary, patient diary) was significantly different (87.5% vs. 90.6% vs. 93.1% vs. 93.3%, respectively, p=0.0002). Adjusted mean symptom severity was significantly lower for the EM "adherent" group than for the EM "nonadherent" group over the 12 weeks of treatment (35.6 vs. 43.8, p=0.008).
CONCLUSION: Overall, EM medication adherence for the depressed youth in this study is high. Compared with EM, there is a tendency of pill counts and medication diaries to overestimate medication adherence. However, pill count adherence better approximates EM adherence, and compliance with returning medication diaries is poor. Youth who are adherent to fluoxetine treatment have lower symptom severity over the course of treatment. Recommendations are provided.
Authors:
Paul A Nakonezny; Carroll W Hughes; Taryn L Mayes; Kathryn H Sternweis-Yang; Betsy D Kennard; Matthew J Byerly; Graham J Emslie
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of child and adolescent psychopharmacology     Volume:  20     ISSN:  1557-8992     ISO Abbreviation:  J Child Adolesc Psychopharmacol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-26     Completed Date:  2011-04-28     Revised Date:  2012-05-07    
Medline Journal Info:
Nlm Unique ID:  9105358     Medline TA:  J Child Adolesc Psychopharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  431-9     Citation Subset:  IM    
Affiliation:
Division of Biostatistics, Department of Clinical Sciences, UT Southwestern Medical Center, Dallas, Texas 75390-8828, USA. paul.nakonezny@utsouthwestern.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00158301;  NCT00332787
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Antidepressive Agents, Second-Generation / therapeutic use*
Child
Depressive Disorder, Major / diagnosis,  drug therapy*
Drug Monitoring
Female
Fluoxetine / therapeutic use*
Humans
Male
Medication Adherence*
Psychiatric Status Rating Scales
Treatment Outcome
Grant Support
ID/Acronym/Agency:
R01 MH039188-17/MH/NIMH NIH HHS; R01 MH039188-18/MH/NIMH NIH HHS
Chemical
Reg. No./Substance:
0/Antidepressive Agents, Second-Generation; 54910-89-3/Fluoxetine
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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