Patient Experience of Antidepressants

Question 1

How do people take their medicines?

Answer 1

• Only 16% take a new prescribed medicine as prescribed
• Almost 1/3 of patients non-adherent after 10 days:
  > 55% do not realise they are not adhering
  > 45% intentionally non-adherent.

Question 2

What are the 4 principles of Medicines Optimisation?

Answer 2

1) To understand the patient’s experience
2) Evidence-based choice of medicines
3) Ensure medicines use is as safe as possible
4) Make medicines optimisation part of routine practice

Question 3

Depression. Key facts? (Number of Rxs? Cost?)

Answer 3

• WHO; leading cause of disability in the world
• Over 50 million Rxs (excluding amitriptyline)
• Cost; 211,145,435 GBP

Question 4

What are the major reasons for stopping antidepressant therapy?

Answer 4

• ADRs and/or unsatisfactory interactions w/HCPs

- Lack of information about antidepressants major cause of dissatisfaction; shaping attitude towards antidepressants

Question 5

What do patients want to know about antidepressants?

Answer 5

• Immediate impact of taking them? S/Es?
• Do they work? How they do they affect your symptoms?
• Does the PIL put you off?
• Can you switch if one isn’t right? Can you come off and go back on then?
• Are they addictive?

Question 6

What are the key messages for HCPs when treating a patient for depression?

Answer 6

• Keep a close eye on patients, provide on-going support
• Continuity of care; know the patient’s story
• Be up-front about potential ADRs/SEs, and how to cope with them
• Counsel patient that another antidepressant could be more effective if the one they’ve tried isn’t
• Understand patient’s concerns in context of their daily lives; look at the ‘bigger picture’, treat them as an individual
• Internet; raft of information - direct patients to reliable sources e.g. NHS Choices
• People want information about: symptoms, about depression and how it’s treated, about the antidepressants they’ve been prescribed, S/Es, other people’s experiences
• Patients want to be involved in decisions about their treatment, and to know what to expect.

Question 7

What attitudes can patients have with antidepressants?

Answer 7

• Despite the increased sense of an ability to function normally, antidepressants reduced patients’ own inner sense of feeling normal
• ‘Unnatural’ to be on them; threat to a person’s ‘authentic self’
• Patients may accept they need medication to feel ‘normal’, but ask whether it is normal to take medication?