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With a little help from my friends?: racial and gender differences in the role of social support in later-life depression medication adherence

Published online by Cambridge University Press:  22 May 2017

Lauren B. Gerlach ,
Janet Kavanagh ,
Daphne Watkins ,
Claire Chiang ,
Hyungjin M. Kim  and
Helen C. Kales
Lauren B. Gerlach*
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
Janet Kavanagh
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
Daphne Watkins
Affiliation:
School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
Claire Chiang
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
Hyungjin M. Kim
Affiliation:
Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan, USA
Helen C. Kales
Affiliation:
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
*
Correspondence should be addressed to: Lauren B. Gerlach, DO, Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, Michigan 48109, USA. Phone: +734-764-0231; Fax: 734-647-8535. Email: glauren@med.umich.edu.
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Abstract

Background:

Social support has been shown to be an important factor in improving depression symptom outcomes, yet less is known regarding its impact on antidepressant medication adherence. This study sought to evaluate the role of perceived social support on adherence to new antidepressant medication prescriptions in later-life depression.

Methods:

Data from two prospective observational studies of participants ≥60 years old, diagnosed with depression, and recently prescribed a new antidepressant (N = 452). Perceived social support was measured using a subscale of the Duke Social Support Index and medication adherence was assessed using a validated self-report measure.

Results:

At four-month follow up, 68% of patients reported that they were adherent to antidepressant medication. Examining the overall sample, logistic regression analysis demonstrated no significant relationship between perceived social support and medication adherence. However, when stratifying the sample by social support, race, and gender, adherence significantly differed by race and gender in those with inadequate social support: Among those with low social support, African-American females were significantly less likely to adhere to depression treatment than white females (OR = 4.82, 95% CI = 1.14–20.28, p = 0.032) and white males (OR = 3.50, 95% CI = 1.03–11.92, p = 0.045).

Conclusions:

There is a significant difference in antidepressant medication adherence by race and gender in those with inadequate social support. Tailored treatment interventions for low social support should be sensitive to racial and gender differences.

Keywords

later-life depressionantidepressant adherencesocial support
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 9 , September 2017 , pp. 1485 - 1493
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Blazer, D. (2005). Depression and social support in late life: a clear but not obvious relationship. Aging & Mental Health, 9, 497–499.CrossRefGoogle Scholar
Bosworth, H. B., Hays, J. C., George, L. K. and Steffens, D. C. (2002). Psychosocial and clinical predictors of unipolar depression outcome in older adults. International Journal of Geriatric Psychiatry, 17, 238–246.CrossRefGoogle ScholarPubMed
Burnett-Zeigler, I. et al. (2014). The association between race and gender, treatment attitudes, and antidepressant treatment adherence. International Journal of Geriatric Psychiatry, 29, 169–177.CrossRefGoogle ScholarPubMed
Callahan, C. M. et al. (2002). Six-item screener to identify cognitive impairment among potential subjects for clinical research. Medical Care, 40, 771–781.CrossRefGoogle ScholarPubMed
Dalgard, O. S. et al. (2006). Negative life events, social suport and gender difference in depression: a multinational community survey with data from the ODIN study. Social Psychiatry Psychiatric Epidemiology, 41, 444–451.CrossRefGoogle Scholar
Datto, C. J., Oslin, D. W., Streim, J. E., Scheinthal, S. M., Difilippo, S. and Katz, I. (2002). Pharmacologic treatment of depression in nursing home residents: a mental health services perspective. Journal of Geriatric Psychiatry and Neurology, 15, 141–146.CrossRefGoogle ScholarPubMed
Elliott, M. (2001). Gender differences in causes of depression. Women & Health, 33, 183–198.CrossRefGoogle ScholarPubMed
Fortney, J. C. et al. (2011). Reasons for antidepressant nonadherence among veterans treated in primary care clinics. Journal of Clinical Psychiatry, 72, 827–834.CrossRefGoogle ScholarPubMed
Gallo, J. J. and Rabins, P. V. (1999). Depression without sadness: alternative presentations of depression in late life. American Family Physician, 60, 820–826.Google ScholarPubMed
George, L. K., Blazer, D. G., Hughes, D. C. and Fowler, N. (1989). Social support and the outcome of major depression. British Journal of Psychiatry, 154, 478–485.CrossRefGoogle ScholarPubMed
Hays, J. C. Steffens, D. C., Flint, E. P., Bosworth, H. B. and George, L. K. (2001). Does social support buffer functional decline in elderly patients with unipolar depression? American Journal of Psychiatry, 158, 1850–1855.CrossRefGoogle ScholarPubMed
Holt-Lunstad, J., Smith, T. B. and Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLOS Medicine, 7, e1000316.CrossRefGoogle Scholar
Hughes, D. C., Blazer, D. G. and Hybels, C. (1993). The Duke Social Support Index (DSSI): A Working Paper Revised. Durham, NC: Duke University Center for the Study of Aging and Human Development.Google Scholar
Kales, H. C. et al. (2013). Racial differences in adherence to antidepressant treatment in later life. American Journal of Geriatric Psychiatry, 21, 999–1009.CrossRefGoogle ScholarPubMed
Kales, H. C. et al. (2016). Predictors of antidepressant nonadherence among older veterans with depression. Psychiatric Services, 67, 728–734.CrossRefGoogle ScholarPubMed
Kendler, K. S., Meyers, J. and Prescott, C. A. (2005). Sex differences in the relationship between social support and risk for major depression: a longitudinal study of opposite-sex twin pairs. American Jouranl of Psychiatry, 162, 250–256.CrossRefGoogle ScholarPubMed
Krause, N. (2006). Exploring the stress-buffering effects of church-based and secular social support on self-rated health in late life. Journal of Gerontology: Social Sciences, 61, S35–43.CrossRefGoogle ScholarPubMed
Krivoy, A. et al. (2015). Adherence to antidepressant therapy and mortality rates in ischaemic heart disease: cohort study. British Journal of Psychiatry, 206, 297–301.Google ScholarPubMed
Kurlowicz, L. H. (1993). Social factors and depression in late life. Archives of Psychiatric Nursing, 7, 30–36.CrossRefGoogle ScholarPubMed
Landerman, R., George, L. K., Campbell, R. T. and Blazer, D. G. (1989). Alternative models of the stress buffering hypothesis. American Journal of Community Psychology, 17, 625–642.CrossRefGoogle ScholarPubMed
Lee, M. S. et al. (2010). Variables influencing antidepressant medication adherence for treating outpatients with depressive disorders. Journal of Affective Disorders, 123, 216–221.CrossRefGoogle ScholarPubMed
Olstad, R., Sexton, H. and Soggard, A. J. (2001). The finnmark study. A prospective population study of the social support buffer hypothesis, specific stressors, and mental distress. Social Psychiatry Psychiatric Epidemiology, 36, 582–589.CrossRefGoogle ScholarPubMed
Prins, M. A., Verhaak, P. F., Bensing, J. M. and Van Der Meer, K. (2008). Health beliefs and perceived need for mental health care of anxiety and depression–the patients' perspective explored. Clinical Psychology Review, 28, 1038–1058.CrossRefGoogle ScholarPubMed
Schaefer, C., Coyne, J. C. and Lazarus, R. S. (1981). The health-related functions of social support. Journal of Behavioral Medicine, 4, 381–406.CrossRefGoogle ScholarPubMed
Sirey, J. A., Bruce, M. L. and Kales, H. C. (2010). Improving antidepressant adherence and depression outcomes in primary care: the treatment initiation and participation (TIP) program. American Journal of Geriatric Psychiatry, 18, 554–562.CrossRefGoogle ScholarPubMed
Svarstad, B. L., Chewning, B. A., Sleath, B. L. and Claesson, C. (1999). The brief medication questionnaire: a tool for screening patient adherence and barriers to adherence. Patient Education and Counseling, 37, 113–124.CrossRefGoogle ScholarPubMed
Valenstein, M. et al. (2009). Higher-risk periods for suicide among VA patients receiving depression treatment: prioritizing suicide prevention efforts. Journal of Affective Disorders, 112, 50–58.CrossRefGoogle ScholarPubMed
Voils, C. I., Steffens, D. C., Flint, E. P. and Bosworth, H. B. (2005). Social support and locus of control as predictors of adherence to antidepressant medication in an elderly population. American Journal of Geriatric Psychiatry, 13, 157–165.CrossRefGoogle Scholar
Wu, J. R., Frazier, S. K. Rayens, M. K. Lennie, T. A., Chung, M. L. and Moser, D. K. (2013). Medication adherence, social support, and event-free survival in patients with heart failure. Health Psychology, 32, 637–646.CrossRefGoogle ScholarPubMed
Zivin, K. and Kales, H. C. (2008). Adherence to depression treatment in older adults: a narrative review. Drugs and Aging, 25, 559–571.Google ScholarPubMed