Early self-reported medication non-adherence in depression: A hospital-based prospective study from Northeast India
Apoorva Upadhyay, Geeta Soohinda, Harshavardhan Sampath, Sanjiba DuttaABSTRACT
Background:
Early medication nonadherence represents a critical barrier to achieving optimal outcomes in major depressive disorder (MDD). Despite India’s high depression burden, only a few studies have examined psychosocial factors associated with early nonadherence in routine clinical settings.
Aim:
To evaluate the prevalence and psychosocial factors associated with early self-reported medication nonadherence in depression within 1 month of treatment in a psychiatric outpatient department.
Methods:
A prospective cohort study included 101 adults diagnosed with MDD at a tertiary hospital in Northeast India who were antidepressant-naïve for the current episode and attended their first follow-up within a month. Sociodemographic and clinical factors, depression severity, and stigma were assessed at baseline. Medication adherence and medication attitudes were assessed at follow-up.
Results:
Early self-reported medication nonadherence occurred in 27.7% of patients. In bivariate analysis, nonadherence was associated with longer episode duration, treatment-emergent side effects, higher personal and perceived stigma, and poorer medication attitudes. In logistic regression, higher perceived stigma was associated with increased odds of early medication nonadherence (OR = 1.31, 95% CI: 1.04 to 1.67,
Conclusion:
Nearly one-third of MDD patients self-reported early medication nonadherence. Psychosocial determinants, particularly stigma and negative medication attitudes, played a greater role than demographic or clinical factors. Early psychoeducation and stigma-reduction strategies could be crucial for enhancing medication adherence and improving treatment outcomes in depression.