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Older patients' aversion to antidepressants. A qualitative study.
- Source :
-
Journal of general internal medicine [J Gen Intern Med] 2006 Feb; Vol. 21 (2), pp. 146-51. Date of Electronic Publication: 2005 Dec 07. - Publication Year :
- 2006
-
Abstract
- Background: Depression is common among older patients yet is often inadequately treated. Patient beliefs about antidepressants are known to affect treatment initiation and adherence, but are often not expressed in clinical settings.<br />Objective: To explore attitudes toward antidepressants in a sample of depressed, community-dwelling elders who were offered treatment. DESIGN. Cross-sectional, qualitative study utilizing semi-structured interviews.<br />Participants: Primary care patients age 60 years and over with depression, from academic and community primary care practices of the University of Pennsylvania Health System and the Philadelphia Department of Veterans Affairs. Patients participated in either the Prevention of Suicide in Primary Care Elderly: Collaborative Trial or the Primary Care Research in Substance Abuse and Mental Health for the Elderly Trial. Sixty-eight patients were interviewed and responses from 42 participants with negative attitudes toward medication for depression were analyzed.<br />Measurements: Interviews were audiotaped, transcribed, and entered into a qualitative software program for coding and analysis. A multidisciplinary team of investigators coded the transcripts and identified key features of narratives expressing aversion to antidepressants.<br />Results: Four themes characterized resistance to antidepressants: (1) fear of dependence; (2) resistance to viewing depressive symptoms as a medical illness; (3) concern that antidepressants will prevent natural sadness; (4) prior negative experiences with medications for depression.<br />Conclusions: Many elders resisted the use of antidepressants. Patients expressed concerns that seem to reflect their concept of depression as well as their specific concerns regarding antidepressants. These findings may enhance patient-provider communication about depression treatment in elders.
- Subjects :
- Aged
Aged, 80 and over
Antidepressive Agents adverse effects
Attitude to Health
Cross-Sectional Studies
Fear
Female
Humans
Interviews as Topic
Male
Medical Records
Middle Aged
Substance-Related Disorders etiology
Aging psychology
Antidepressive Agents therapeutic use
Depression drug therapy
Depression psychology
Patient Acceptance of Health Care
Patients psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1525-1497
- Volume :
- 21
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of general internal medicine
- Publication Type :
- Academic Journal
- Accession number :
- 16336620
- Full Text :
- https://doi.org/10.1111/j.1525-1497.2005.00296.x