Differentiated information on antidepressants at hospital discharge: a hypothesis-generating study

Int J Pharm Pract. 2013 Aug;21(4):252-62. doi: 10.1111/ijpp.12001. Epub 2012 Nov 19.

Abstract

Objectives: This hypothesis-generating study examined the clinical, humanistic and economic impact of providing differentiated medication information depending on the patient's information desire as compared with undifferentiated information to patients with a major depressive episode at hospital discharge.

Methods: A longitudinal multi-centre study with quasi-experimental design comprised two experimental groups ((un)differentiated antidepressant information) and one 'no information' group. Patients were followed up for 1 year assessing adherence, economic outcomes (i.e. costs of medicines, consultations, productivity loss and re-admissions), clinical outcomes (i.e. depressive, anxiety and somatic symptoms and side effects) and humanistic outcomes (i.e. quality of life, satisfaction with information). A linear model for repeated measures was applied to assess differences over time and between groups.

Key findings: Ninety-nine patients participated. Still participating 1 year later were 78. No beneficial effect was observed for adherence. Lower productivity loss (P = 0.021) and costs of consultations with healthcare professionals (P = 0.036) were observed in the differentiated group. About one-third of patients were re-admitted within 1 year following discharge. Patients in the 'no information' group had significantly more re-admissions than patients in the undifferentiated group (P = 0.031).

Conclusions: The hypothesis of differentiated information could be supported for economic outcomes only. Future medication therapy intervention studies should apply a more rigorous study design.

Keywords: costs; depression; medicine information services; patient adherence; psychiatric hospitals.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / therapeutic use*
  • Depressive Disorder, Major / drug therapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Male
  • Medication Adherence
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Discharge*
  • Patient Education as Topic / methods*
  • Patient Satisfaction
  • Quality of Life
  • Treatment Outcome

Substances

  • Antidepressive Agents