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Adherence to Antidepressant Medications in Black and Latino Elderly Patients

Received February 25, 2004; revised May 3, May 25, 2004; accepted May 27, 2004. From the Univ. of California, San Francisco. Send correspondence and reprint requests to Liat Ayalon, Ph.D., Univ. of California, San Francisco, 401 Parnassus Ave., CPT, San Francisco, CA 94143. e-mail: liata{at}lppi.ucsf.edu
© 2005 American Association for Geriatric Psychiatry

Objective: The purpose of this pilot study was to identify ethnic group differences in nonadherence and to determine predictors of nonadherence to antidepressant medications in older minority-group members. Methods: Participants were 49 black and 52 Latino subjects over the age of 55 who had been prescribed antidepressant medications within the past 12 months. Results: We found a distinction between intentional nonadherence (e.g., alteration of medication regimen to fit one’s needs) and unintentional nonadherence (e.g., forgetfulness/ difficulties keeping track of medication regimen). Results suggested that older Latino subjects reported significantly more unintentional nonadherence than older black subjects. However, once other predictors were entered into the model, ethnicity did not remain a significant predictor. No ethnic group differences in intentional nonadherence were suggested. After controlling for ethnicity and medication type, intentional nonadherence was associated with concerns about the side effects of antidepressant medications, the stigma associated with antidepressant medications, and the attribution of lesser importance to antidepressant medications than other medications. Unintentional nonadherence was associated with greater cognitive impairment. Conclusions: Results suggest that the two ethnic minority groups face similar barriers to adherence to antidepressant medications. Interventions to increase adherence should target the specific type of nonadherence presented by the elderly patients. Some may benefit from memory aids and the assistance of family and friends, others from specific educational interventions about the nature of depression and antidepressant medications.

Key Words: Antidepressants • Cross-Cultural Issues • Black Patients • Latino Patients • Medication Compliance

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