Abstract
BackgroundNonadherence to antidepressants is a major obstacle to deriving antidepressants’ therapeutic benefits, resulting in significant burdens on the individuals and the health care system. Several studies have shown that nonadherence is weakly associated with personal and clinical variables but strongly associated with patients’ beliefs and attitudes toward medications. Patients’ drug review posts in online health care communities might provide a significant insight into patients’ attitude toward antidepressants and could be used to address the challenges of self-report methods such as patients’ recruitment.ObjectiveThe aim of this study was to use patient-generated data to identify factors affecting the patient’s attitude toward 4 antidepressants drugs (sertraline [Zoloft], escitalopram [Lexapro], duloxetine [Cymbalta], and venlafaxine [Effexor XR]), which in turn, is a strong determinant of treatment nonadherence. We hypothesized that clinical variables (drug effectiveness; adverse drug reactions, ADRs; perceived distress from ADRs, ADR-PD; and duration of treatment) and personal variables (age, gender, and patients’ knowledge about medications) are associated with patients’ attitude toward antidepressants, and experience of ADRs and drug ineffectiveness are strongly associated with negative attitude.MethodsWe used both qualitative and quantitative methods to analyze the dataset. Patients’ drug reviews were randomly selected from a health care forum called askapatient. The Framework method was used to build the analytical framework containing the themes for developing structured data from the qualitative drug reviews. Then, 4 annotators coded the drug reviews at the sentence level using the analytical framework. After managing missing values, we used chi-square and ordinal logistic regression to test and model the association between variables and attitude.ResultsA total of 892 reviews posted between February 2001 and September 2016 were analyzed. Most of the patients were females (680/892, 76.2%) and aged less than 40 years (540/892, 60.5%). Patient attitude was significantly (P<.001) associated with experience of ADRs, ADR-PD, drug effectiveness, perceived lack of knowledge, experience of withdrawal, and duration of usage, whereas oth age (F4,874=0.72, P=.58) and gender (χ24=2.7, P=.21) were not found to be associated with patient attitudes. Moreover, modeling the relationship between variables and attitudes showed that drug effectiveness and perceived distress from adverse drug reactions were the 2 most significant factors affecting patients’ attitude toward antidepressants.ConclusionsPatients’ self-report experiences of medications in online health care communities can provide a direct insight into the underlying factors associated with patients’ perceptions and attitudes toward antidepressants. However, it cannot be used as a replacement for self-report methods because of the lack of information for some of the variables, colloquial language, and the unstructured format of the reports.
Highlights
● During 2011–2014, 12.7% of persons aged 12 and over, 8.6% of males, and 16.5% of females took antidepressant medication in the past month
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Summary
● During 2011–2014, 12.7% of persons aged 12 and over, 8.6% of males, and 16.5% of females took antidepressant medication in the past month. ● For both males and females, non-Hispanic white persons were more likely to take antidepressant medication compared with those of other race and Hispanic-origin groups. While the majority of antidepressants are taken to treat depression, antidepressants can be taken to treat other conditions, like anxiety disorders This Data Brief provides the most recent estimates of antidepressant use in the U.S noninstitutionalized population, including prevalence of use by age, sex, race and Hispanic origin, and length of use. In 2011–2014, 12.7% of persons aged 12 and over reported antidepressant medication use in the past month. ● Overall and in each age group, females were about twice as likely as males to take antidepressant medication (Figure 1).
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