Patient adherence with antidepressant treatment

Reading the article by Pampallona et al (2002) on patient adherence in the treatment of depression, I sought in vain for any overt indication that mental health service users themselves were routinely being asked for their views, either by practitioners or by researchers. ‘Patient education’ and ‘education of the patient's family’ may well be interventions worthy of study, but methodologies used to look at this problem appear to fail to take account of what mental health professionals can learn from patients, families and carers.

A recent survey of over 2600 service users and carers, undertaken by the National Schizophrenia Fellowship, the Manic Depression Fellowship and Mind (Hogman & Sandamas, 2001) found that 27% had not had their medicine discussed with them, 46% had not received any written information about the possible side-effects of medicine, and a startling 62% had never been offered a choice of medicine. The survey concluded that, ‘Positive outcomes are increased if people are informed about their choices, allowed to choose and given their choice’. This message seems slowly to be seeping into the consciousness of our political masters, with Hazel Blears, Parliamentary Under Secretary of State for Health, actively promoting increased informed choice for patients, including treating patients as partners in care, and giving them the confidence to take control of their own treatment. When the medical profession as a whole can embrace this in respect of patients with a mental illness then, unlike Pampallona and his colleagues, we may be some way nearer to finding out what interventions work successfully.