Abstract
Background: Patients on antidepressant therapy have no contact with their physicians until their next appointment, which in most cases could be more than two weeks apart. This crucial time is of utmost importance as this could assess the patient's will to follow the prescribed therapy and the general belief about the benefits of using antidepressant treatment. Thus medication adherence is necessary to reduce the risk of suicidal tendencies and mortality in these patients. The study aimed to evaluate medication adherence and adherence to antidepressant therapy in patients with major depressive disorder.
 Methodology: in this cross-sectional study, a total of 101 clinically diagnosed patients with Major Depressive Disorder (MDD) were included in the study from psychiatric and medical OPD from June 2018 to June 2019, from Jinnah Medical College Hospital (JMCH). Belief about medicines questionnaire (BMQ specific and BMQ general), regarding their views about the prescribed medication and the modified questionnaire of the medication adherence scale used, scores were calculated to give a numerical value to measure the adherence to antidepressant medication.
 Results: According to the study, 101 patients with major depressive disorder had an overall good belief about medication but have low adherence. Belief about medicines questionnaire (based on BMQ) BMQ- the specific q1-10 score was 36.54 (necessity, concern), BMQ-general 27.98 score, q11-18 (overuse and harm). Regarding their views about the prescribed medication. 86% of participants with the major depressive disorder had low adherence (scores 0-5), and those with high adherence were only 14% (scores 6-8). The patients diagnosed with the major depressive disorder who had co-morbid (diabetes, hypertension, hypothyroidism, etc.) had better adherence for their prescribed treatment as compared to those without co-morbid.
 Conclusion: This study indicates that although patients with major depressive disorder from tertiary care hospitals in Karachi had a positive belief about medication but have low adherence to antidepressant therapy.
Highlights
According to World Health Organization (WHO), depression is a cause of a major burden on public health globally
Belief about medicine questionnaire (BMQ)[2] is useful as a tool to assess the high risk of non-adherence
This study was conducted in Karachi's population to evaluate adherence to antidepressant medication and belief about medication, where 101 OPD patients diagnosed with Major Depressive Disorder (MDD) were enrolled from
Summary
According to WHO, depression is a cause of a major burden on public health globally. Depression affects over 350 million people globally[1]. Patients on antidepressant therapy have no contact with their physicians until their appointment, which in most cases could be more than two weeks apart This crucial time is of utmost importance as this could assess the patient's will to follow the prescribed therapy and the general belief about the benefits of using antidepressant treatment. The study aimed to evaluate medication adherence and adherence to antidepressant therapy in patients with major depressive disorder. Results: According to the study, 101 patients with major depressive disorder had an overall good belief about medication but have low adherence. Belief about medicines questionnaire (based on BMQ) BMQ- the specific q1-10 score was 36.54 (necessity, concern), BMQ-general 27.98 score, q11-18 (overuse and harm) Regarding their views about the prescribed medication. Conclusion: This study indicates that patients with major depressive disorder from tertiary care hospitals in Karachi had a positive belief about medication but have low adherence to antidepressant therapy
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