Objective: Previous studies have indicated that patient adherence to antidepressant treatment is unsatisfactory. There is, however, little published data on adherence in the South African context. In this pilot study we explore the possible benefits of a consumer psychoeducation program.
Method: First, drop-out rates during the first four months of paroxetine treatment were surveyed in patients participating in a psychoeducational program focused on depression and its treatment. Practitioners were also surveyed about their perceptions of the program. Second, drop-out rates during the first four months of paroxetine treatment were estimated from a pharmacy database of selective serotonin reuptake inhibitor (SSRI) prescriptions in South Africa.
Results: Patients who participated in a psychoeducational program demonstrated comparatively lower drop-out rates during treatment compared with drop-out rates in patients on paroxetine (and other SSRIs) obtained from a national pharmacy database. Improved adherence on the psychoeducational program was attributed to an increased understanding of depression and the need to take medication, a realization that patients are not alone (i.e., depression is a widespread problem) and a better understanding and acceptance of the possible side-effects of medication. Both practitioners and patients were positive about their experience of the program and 80% of doctors judged the program to be very useful.
Conclusion: Drop-out rates during SSRI treatment in South Africa appear to be unacceptably high, whether or not patients receive concomitant benzodiazepines. Psychoeducational programs may prove valuable in increasing adherence to treatment regimes.