@article{e8d7d88b84c94fd98ad44c222c3110a8,
title = "Predicting Medication Nonadherence in Older Adults With Difficult-to-Treat Depression in the IRL-GRey Randomized Controlled Trial",
abstract = "Objective: Nonadherence to antidepressants interferes with optimal treatment of late-life depression. This analysis examines clinical and treatment factors predicting medication nonadherence in difficult-to-treat late-life depression. Methods: Secondary analysis of data from a clinical trial of antidepressant pharmacotherapy for Major Depressive Disorder in 468 adults aged 60+ years. All participants received venlafaxine XR for 12 weeks. Nonremitters were randomized to augmentation with either aripiprazole or placebo for 12 additional weeks. Medication adherence was assessed 14 times over 24 weeks. The analyses examined sociodemographic, clinical, and treatment factors that may predict antidepressant nonadherence during early (weeks 1–6), late (weeks 7–12), and augmentation (weeks 13-–24) treatment. Results: Poor cognitive function and early response were predictive of early nonadherence. Poor cognitive function and prior nonadherence were predictive of late nonadherence. Living alone was associated with nonadherence both late and during augmentation treatment. Conclusion: Future studies should consider the role of early response and cognitive function to improve antidepressant adherence, particularly among older adults who live alone.",
keywords = "Aging, antidepressants, geriatrics, major depressive disorder, mental health, randomized controlled trial",
author = "Altmann, {Helene M.} and Joseph Kazan and Gebara, {Marie Anne} and Blumberger, {Daniel M.} and Karp, {Jordan F.} and Lenze, {Eric J.} and Mulsant, {Benoit H.} and Reynolds, {Charles F.} and Stahl, {Sarah T.}",
note = "Funding Information: BHM currently receives support from the Labatt Family Chair in Biology of Depression in Late-Life Adults at the University of Toronto, Brain Canada, the Canadian Institutes of Health Research, the CAMH Foundation, the Patient-Centered Outcomes Research Institute (PCORI), the US National Institute of Health (NIH), Capital Solution Design LLC (software used in a study founded by CAMH Foundation), and HAPPYneuron (software used in a study founded by Brain Canada). He has been an unpaid consultant to Myriad Neuroscience. Funding Information: EJL reports research funding from the COVID Early Treatment Fund, Mercatus Center Emergent Ventures, the Skoll Foundation, the Taylor Family Institute for Innovative Psychiatric Research, the Center for Brain Research in Mood Disorders, the Patient-Centered Outcomes Research Institute, Janssen, and the Barnes Jewish Foundation. Consulting fees: Janssen, Jazz Pharmaceuticals. Patent: Has applied for a patent for the use of fluvoxamine in the treatment of COVID-19. Funding Information: DMB has received research support from the Canadian Institutes of Health Research (CIHR), National Institute of Health (NIH), Brain Canada and the Temerty Family through the Centre for Addiction and Mental Health (CAMH) Foundation and the Campbell Research Institute. He received research support and in-kind equipment support for an investigator-initiated study from Brainsway Ltd. and he is the site principal investigator for a sponsor-initiated study for Brainsway Ltd. He also receives in-kind equipment support from Magventure for investigator-initiated studies. He received medication supplies for an investigator-initiated trial from Indivior. Funding Information: CFR has received research support from the NIH, the Patient Centered Outcomes Research Institute, the Center for Medicare and Medicaid Services, the American Foundation for Suicide Prevention, the Brain and Behavior Research Foundation, and the Commonwealth of Pennsylvania. BristolMeyerSquib and Pfizer have provided pharmaceutical supplies for his NIH sponsored research. He is also a paid consultant for Merck. Publisher Copyright: {\textcopyright} 2022 American Association for Geriatric Psychiatry",
year = "2022",
month = sep,
doi = "10.1016/j.jagp.2022.03.002",
language = "English",
volume = "30",
pages = "994--1002",
journal = "American Journal of Geriatric Psychiatry",
issn = "1064-7481",
number = "9",
}