Just keep taking the tablets: adherence to antidepressant treatment in older people in primary care

Int J Geriatr Psychiatry. 2002 Aug;17(8):752-7. doi: 10.1002/gps.688.


Background: poor adherence to antidepressant medication may account for a significant proportion of treatment failures. Adherence levels and factors associated with adherence have not previously been studied in older people.

Objectives: to report the prevalence and correlates of adherence to antidepressants in people > or = 65 years of age in a primary care setting.

Method: sixty-seven patients currently being prescribed antidepressants from a single rural general practice were assessed using a range of questionnaires measuring adherence to antidepressants, severity of depression, specific health education about antidepressants, level of side-effects, insight, positive and negatives beliefs about medication in general and antidepressants in particular, level of intellectual functioning (past and present), a past history of recovery from depression, type of antidepressant, complexity of prescriptions, age and living arrangements.

Results: forty-five participants (67.2%) were fully adherent; seven (10.4%) mostly adherent, three (4.5%) adhered sometimes, three rarely and nine (13.4%) never. Backwards linear regression found that adherence increased with information given and cognitive impairment and decreased with concerns about taking antidepressants and severity of side-effects.

Conclusions: non-adherence to antidepressant medication is a significant problem in older patients. Our study probably overestimated adherence as it was self-report, which usually overestimates adherence and the refusals are more likely to have been people not taking tablets but still found nearly one third of the patients were non-adherent. An intervention comprising education, eliciting and addressing specific concerns about antidepressant medication and using medication, which minimises side effects, may be helpful.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / therapeutic use*
  • Cognition Disorders / diagnosis
  • Cognition Disorders / epidemiology
  • Cognition Disorders / etiology
  • Depressive Disorder / drug therapy*
  • Depressive Disorder / psychology
  • Female
  • Humans
  • Male
  • Neuropsychological Tests
  • Patient Compliance / statistics & numerical data*
  • Prevalence
  • Rural Population
  • Surveys and Questionnaires


  • Antidepressive Agents