In the popular imagination, depression is chronic sadness. In reality, it is a devastating illness with widespread mental and physical health effects. One of the most common challenges of depression is a motivation deficit. People with depression can struggle to garner the motivation to engage in even mundane self-care activities, intensifying their symptoms. This lack of motivation can also make it difficult to adopt lifestyle changes that treat depression, such as getting more exercise or attending therapy.
It should come as no surprise, then, that motivation deficits can make depression medication compliance difficult. At least 50 percent of people with depression have poor adherence to their medications. This poor adherence can extend to other medications, triggering a cascade of preventable health symptoms.
Depression remains one of the most common chronic illnesses. It is the leading cause of disability worldwide. It is also highly treatable, yet many patients either do not seek or do not comply with treatment. Medicare costs for patients with a history of depression are more than double that of those with no depression history.
AllazoHealth supports interventions that encourage medication compliance and safety. As part of that mission, we conducted a study to examine the so-called “antidepressant halo effect,” which suggests that antidepressant compliance also improves compliance with other medications.
AllazoHealth Studies Depression Medication Compliance Halo Effect
To examine the relationship between antidepressants and drug compliance, we analyzed historical data across a population of approximately 45,000 Medicare Advantage Part D participants. The objective was to better understand the relationship between patient adherence to antidepressants and the three major medication classes impacting STAR ratings: oral anti-diabetics, RAS antagonists, and statins.
We defined medication adherence as achieving an 80 percent or greater proportion of days covered (PDC).
How Antidepressant Compliance Extends to Other Drugs
Our results point to a clear halo effect. The largest impact was on statin compliance, with patient adherence to antidepressant medications increasing statin adherence by 33 percent. The figure for oral anti-diabetics and RAS antagonists was 28 percent.
A reverse of this trend also held true. Patients whose antidepressant medication compliance decreased also decreased compliance with other medications. This hints at depression’s role in worsening medical conditions and shows that antidepressant noncompliance may be a key driver of healthcare costs.
Although the data did not establish a causal connection, it further supports the frequently observed connection between depression and medication compliance, and between depression and worsening health. The data suggest that supporting patients to become compliant with antidepressants may help them adhere to other drug regimens, ultimately improving their quality of life and reducing healthcare expenditures.
Many factors play a role in antidepressant noncompliance, including:
- Misconceptions about the disease, including the mistaken belief that depression is not chronic or that feeling better means it is gone.
- Comorbidities that affect cognition or the ability to be compliant.
- Medication side effects.
- Sociocultural factors, including family support and beliefs about depression.
- Physician-patient communications, especially when a physician does not fully educate a patient about depression.
Addressing these factors can improve patient outcomes. AllazoHealth develops targeted interventions to support the most vulnerable patients and improve compliance.