Discontinuation of antidepressant medication among Latinos in the USA.

Heller School for Social Policy and Management, Brandeis University, Волтам, Massachusetts, United States
The Journal of Behavioral Health Services & Research (Impact Factor: 1.03). 08/2007; 34(3):329-42. DOI: 10.1007/s11414-007-9070-6
Source: PubMed

ABSTRACT Despite recent growth in the variety of antidepressant medications available, many patients discontinue medication prematurely for reasons such as nonresponse, side effects, stigma, and miscommunication. Some analysts have suggested that Latinos may have higher antidepressant discontinuation rates than other US residents. This paper examines Latino antidepressant discontinuation, using data from a national probability survey of Latinos in the USA. In this sample, 8% of Latinos had taken an antidepressant in the preceding 12 months. Among those users, 33.3% had discontinued taking antidepressants at the time of interview, and 18.9% had done so without prior input from their physician. Even controlling for clinical and other variables, patients who reported good or excellent English proficiency were less likely to stop at all. Patients were also less likely to stop if they were older, married, had public or private insurance, or had made eight or more visits to a nonmedical therapist.

Download full-text


Available from: Margarita Alegria, Oct 10, 2014
  • Source
    • "Excluded from this table are the results of review studies and the original articles of Edlund et al. (2008); Einarson (2009); Hirschfeld (1998); Hirschfeld et al. (1997); Schraufnagel et al. (2006); Meredith et al. (2009); and Hodgkin et al. (2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this study was to ascertain whether there is any evidence of stigma related to the use of antidepressants. Using the PubMed and MEDLINE databases, we searched for the terms stigma, antidepressants, and depression. A protocol was developed to extract information from the papers, which were identified and explored further. Thirty-two papers were identified. We found that the stigma against depression differs from stigma against the use of antidepressants. Stigma against depression does not impact on therapeutic adherence to antidepressant use. Stigma related to antidepressant use appears to be linked with perceived emotional weakness, severity of illness, an inability to deal with problems, and a lack of belief in the therapeutic efficacy of antidepressants. Stigma against medication can be a useful target for interventions, just like the stigma related to depression. However, clinicians must be careful in avoiding the medicalization of symptoms.
    The Journal of nervous and mental disease 11/2011; 199(11):866-71. DOI:10.1097/NMD.0b013e3182388950
  • Source
    • "Although US studies about stigma in Latino patient populations are very few and mostly exploratory, the evidence is highly suggestive. Both quantitative and qualitative reports underscore concerns, especially among foreign-born and less acculturated Latinos, regarding labeling, embarrassment and social discrimination from family, friends and employers impeding acceptance of depression treatment and medication adherence [12] [13] [14]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To develop a validated stigma checklist to assist physicians in addressing depression in Latino patients. Two hundred low-income, Spanish-speaking, Latino patients in primary care clinics were screened for depression using Patient Health Questionnaires (PHQ-2 and PHQ-9), and medical records were reviewed. With the use of a wide pool of stigma items, empirical methods were used to develop a stigma checklist from this primary care sample and patient information was used to demonstrate construct validity. Patients reporting higher levels of perceived stigma using the stigma checklist were less likely to disclose their depression diagnosis to their family and friends (P<.05) and also less likely to be taking depression medication (OR=.78; 95% CI, .62-.99). Patients with stigma were less likely to be able to manage their depression (OR=.79; 95% CI, .65-.96) and more likely to have missed scheduled appointment visits (OR=1.44; 95% CI, 1.03-2.02). Given the strong relationship between stigma and care of depression, primary care clinicians should be aware of and address stigma among their depressed Latino patients. The stigma checklist presented for treating Spanish-speaking Latino patients in primary care may be used to assess depressed patients for stigma to help inform clinical management of patients.
    General hospital psychiatry 03/2010; 32(2):182-91. DOI:10.1016/j.genhosppsych.2009.10.008
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess pharmacists' provision of antidepressant information and to examine the effect of patient ethnicity and language skills on pharmacists' provision of information and patient education. Cross-sectional, randomized, between-subjects study. Wisconsin, from September to November 2008. 540 community pharmacists. Participants were exposed to one of three vignettes describing a patient coming into the pharmacy for an initial dispensation of an antidepressant. Vignettes varied according to patient ethnicity (white or Hispanic) and language spoken (English or Spanish). Respondents' information and education messages given to patients about antidepressants and whether Hispanic patient ethnicity and English language ability reduced pharmacists' communication about antidepressants. A majority of participants would provide information regarding the medication's name (93.3%) and dosage schedule (92.8%). Many pharmacists also reported that they would tell the patient to take the medication on a daily basis (92.6%) and that it takes 2 to 4 weeks for the medication to have a noticeable effect (87.8%). Multivariate models showed that pharmacists would provide significantly less information (β = -0.24 [95% CI -0.31 to -0.17]) and education messages (-0.17 [-0.24 to -0.09]) to Spanish-speaking patients. These findings suggest that Spanish-speaking patients may face disparities in the level of care received from community pharmacists. Interventions should be available to enhance pharmacists' communication with Spanish-speaking patients in an effort to facilitate safe and effective medication use.
    Journal of the American Pharmacists Association 05/2011; 51(3):388-96. DOI:10.1331/JAPhA.2011.09136
Show more