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Beliefs About Antidepressant Medications in Primary Care Patients: Relationship to Self-Reported Adherence

Brown, Charlotte PhD*; Battista, Deena R. PhD*; Bruehlman, Richard MD†; Sereika, Susan S. PhD‡; Thase, Michael E. MD*; Dunbar-Jacob, Jacqueline PhD‡

Original Article

Background: Adherence to medication is unacceptably low in both medical and psychiatric disorders. Explanatory models of illness beliefs and behaviors suggest that an individual's beliefs about a disorder and its treatment will influence their adherence. Given that beliefs about medications may influence adherence to antidepressants, we examined beliefs about medications in relation to antidepressant adherence in a primary care sample.

Objective: The purpose of this report is to 1) describe beliefs about medication in primary care patients prescribed antidepressants for depression; 2) examine the factor structure of the Beliefs about Medicines Questionnaire (BMQ) and compare it with the previously reported factor structure of the BMQ in medical conditions; and 3) examine the association of medication beliefs with self-reported medication adherence.

Results: Factor analysis indicates that the BMQ is valid in a sample of primary care patients receiving treatment for depression and has a similar factor structure to that obtained in samples of patients with chronic medical conditions. Beliefs about medications are significantly associated with self-reported adherence. Severity of depressive symptoms and specific concerns about antidepressants are significantly associated with self-reported medication-taking behavior. Findings suggest that in addition to telling patients how to take their medications, primary care physicians should also educate patients about the short- and long-term effects of the medication, how the medication works, and that antidepressants are not addictive.

From the *University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; †Renaissance Family Practice, Pittsburgh, Pennsylvania; and the ‡University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania.

Supported by a grant from the National Institute of Mental Health (R01 MH60763) to Charlotte Brown, PhD.

Presented as a poster at the “Complexities of Co-occurring Conditions Conference” in Washington, DC, June 2004.

Reprints: Charlotte Brown, PhD, Associate Professor of Psychiatry, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213. E-mail: brownc@upmc.edu.

© 2005 Lippincott Williams & Wilkins, Inc.