Does a personalized psychological intervention improve medication adherence and depressive symptoms in outpatients with depression compared to treatment as usual?
A brief, personalized psychological intervention significantly improved early antidepressant medication adherence in outpatients with depression.
In China’s mental healthcare system, a critical shortage of professionals limits the implementation of guideline-recommended shared decision-making, leading to high rates of antidepressant non-adherence. This study tested whether a brief, theory-based psychological intervention could improve early medication adherence within existing resource constraints. We conducted a parallel-group, assessor-blinded randomized controlled trial at a tertiary hospital in Guangdong. Eighty outpatients with major depressive disorder were randomized to receive either a 12-week personalized intervention or treatment as usual. The personalized intervention, delivered in eight 30-min sessions, integrated a predictive risk algorithm with stage-matched behavioral techniques to target key adherence determinants. The primary outcomes were medication adherence (MMAS-8) and depressive symptoms (SDS). Among the 60 study completers, the intervention group achieved significantly higher medication adherence at 12 weeks than the control group (between-group difference: 1.09 points), representing an 18% relative improvement. Depressive symptoms decreased substantially in both groups, with no between-group difference. The intervention also led to a significant increase in patient autonomy. This theory-guided protocol effectively improved antidepressant adherence without accelerating short-term symptom reduction. This scalable approach shows promise for bridging the treatment gap in routine psychiatric care in China without requiring additional specialist resources.
Cheng et al. (Fri,) studied this question.