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Psychosocial interventions to improve adherence in depressed and anxious older adults prescribed antidepressant pharmacotherapy: a scoping review

机译:提高抑郁和焦虑老年人抗抑郁药物治疗依从性的社会心理干预:范围综述

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摘要

Medication nonadherence in depressed and anxious older adults is prevalent and associated with non-response to antidepressant pharmacotherapy. Evidence-based options to improve medication adherence are limited in this population. To review the state of the literature on the types and efficacy of psychosocial interventions for improving antidepressant pharmacotherapy adherence in depressed and anxious older adults. We conducted a scoping review according to PRISMA-ScR guidelines. PubMed/Medline and article references starting in 1980 up to 28 February 2023 were reviewed. Of the 710 records screened, 4 psychosocial interventions were included in the review. All studies included depressed older adults, and none included anxious older adults. Samples included racial and ethnic minorities and were primarily women. The psychosocial interventions consisted mainly of psychoeducation with usual care as the control comparison. Measures of antidepressant adherence included self-reported adherence or pill counting. Three of the four randomized controlled trials improved medication adherence rates and reduced depression symptom burden. Effective interventions exist for improving antidepressant medication adherence in depressed older adults. Improved adherence can reduce depression symptom burden. The lack of interventions for anxious older adults highlights the need to develop and deliver interventions for anxious older adults prescribed antidepressant pharmacotherapy.
机译:抑郁和焦虑的老年人普遍存在药物不依从性,并且与对抗抑郁药物治疗无反应有关。在该人群中,提高药物依从性的循证选择有限。回顾关于社会心理干预对提高抑郁和焦虑老年人抗抑郁药物治疗依从性的类型和疗效的文献状况。我们根据 PRISMA-ScR 指南进行了范围综述。审查了从 1980 年开始至 2023 年 2 月 28 日的 PubMed/Medline 和文章参考文献。在筛选的 710 条记录中,4 项社会心理干预被纳入本综述。所有研究都纳入了抑郁的老年人,没有一项研究包括焦虑的老年人。样本包括少数种族和民族,主要是女性。社会心理干预主要包括心理教育,常规护理作为对照比较。抗抑郁药依从性的测量包括自我报告的依从性或药丸计数。四项随机对照试验中有三项提高了药物依从率并减轻了抑郁症状负担。存在有效的干预措施可以提高抑郁症老年人的抗抑郁药物依从性。提高依从性可以减轻抑郁症状负担。缺乏针对焦虑老年人的干预措施凸显了为焦虑的老年人制定和提供处方抗抑郁药物治疗的干预措施的必要性。

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