Health care providers' perspectives of medication adherence in the treatment of depression: a qualitative study.

PURPOSE: Non-adherence to antidepressant medications is a significant barrier to the successful treatment of depression. The purpose of this study was to explore the perspectives of health care providers on antidepressant medication non-adherence in clinical practice.

METHODS: Individual semi-structured interviews were conducted with a purposive sample of 31 health care providers from a range of disciplines and settings in the state of New South Wales, Australia. Interviews focused on medication adherence issues in depression and participants' strategies in addressing them. Interviews were audio recorded, transcribed verbatim and thematically content analyzed using a constant comparison approach.

RESULTS: Participants acknowledged medication non-adherence to be a complex problem in depression, and attributed this problem to patient, medication and environmental-specific issues. Five approaches in addressing non-adherence were reported: patient education, building partnerships with patients, pharmacological management, developing behavioural skills and building supportive networks. Challenges to the management of non-adherence were lack of time and skills, assessment of medication adherence, transition period immediately post-discharge and conflicts in views between providers.

CONCLUSION: Participants were able to identify issues and strategies in addressing antidepressant non-adherence; however, barriers were also identified that could impact on providers' ability to address this issue effectively. More research is needed to develop effective multidisciplinary strategies that take into account providers' perspectives in improving adherence to antidepressant medications.