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Open Access Research article

Duration and compliance with antidepressant treatment in immigrant and native-born populations in Spain: a four year follow-up descriptive study

Inés Cruz1*, Catalina Serna23, Montserrat Rué4, Jordi Real13, Jorge Soler-Gonzalez13 and Leonardo Galván5

Author Affiliations

1 Primary Care Research Institute IDIAP J Gol, Catalan Institute of Health, Rambla de Ferran, 44, 3, 25007, Lleida, Spain

2 Regional Primary Care Management Office, Catalan Institute of Health, University of Lleida, Rambla de Ferran, 44, 3, 25007, Lleida, Spain

3 University of Lleida, Rambla de Ferran, 44, 3, 25007, Lleida, Spain

4 Biostatistics Department, University of Lleida, Montserrat Roig, 2, 25006, Lleida, Spain

5 Pharmacy Unit, Catalan Department of Health, Rovira Roure, 2, 25006, Lleida, Spain

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BMC Public Health 2012, 12:256  doi:10.1186/1471-2458-12-256

Published: 2 April 2012

Abstract

Background

Non-compliance with antidepressant treatment continues to be a complex problem in mental health care. In immigrant populations non-compliance is one of several barriers to adequate management of mental illness; some data suggest greater difficulties in adhering to pharmacological treatment in these groups and an increased risk of therapeutic failure.

The aim of this study is to assess differences in the duration and compliance with antidepressant treatment among immigrants and natives in a Spanish health region.

Methods

Population-based (n=206,603), retrospective cohort study including all subjects prescribed ADT between 2007 and 2009 and recorded in the national pharmacy claims database. Compliance was considered adequate when the duration was longer than 4months and when patients withdrew more than 80% of the packs required.

Results

5334 subjects (8.5% of them being immigrants) initiated ADT. Half of the immigrants abandoned treatment during the second month (median for natives=3months). Of the immigrants who continued, only 29.5% presented good compliance (compared with 38.8% in natives). The estimated risk of abandoning/ending treatment in the immigrant group compared with the native group, adjusted for age and sex, was 1.28 (95%CI 1.16-1.42).

Conclusions

In the region under study, immigrants of all origins present higher percentages of early discontinuation of ADT and lower median treatment durations than the native population. Although this is a complex, multifactor situation, the finding of differences between natives and immigrants in the same region suggests the need to investigate the causes in greater depth and to introduce new strategies and interventions in this population group.