Motivational Interviewing to Improve Medication Adherence Among Hispanic Adults With Depression

Phase 1

Completed

Conditions: Depression

Interventions: Behavioral: Motivational interviewing
Behavioral: Treatment as usual

Registration Number: NCT00356304

Lead Sponsor: University of Medicine and Dentistry of New Jersey

Brief Summary: This study will determine the effectiveness of motivational interviewing in improving antidepressant medication adherence among Hispanics.

Detailed Description: Depression is a serious mental illness characterized by symptoms that can interfere with a person's ability to work, study, eat, sleep, and enjoy activities that were once pleasurable. Studies have shown that people of Hispanic descent tend to underutilize mental health care services. Additionally, Hispanics have demonstrated lower compliance and completion rates for antidepressant treatment. This may be due to low socioeconomic status, lack of family financial support, and inadequate communication with mental health care providers. Motivational interviewing is a goal-oriented type of therapy that focuses on eliciting behavior change by identifying and mobilizing a person's values. This study will determine the effectiveness of culturally sensitive motivational interviewing in improving antidepressant medication adherence in Hispanics.

Participants in this 6-month, open-label study will be randomly assigned to receive either motivational interviewing in addition to their antidepressant therapy or treatment as usual. All participants will first attend a 45-minute screening visit, which will include questionnaires and an interview about psychiatric symptoms, medication attitudes, and medication adherence behavior. Participants will also receive an electronic medication container that will record how consistently medication is taken. Participants assigned to motivational interviewing will then attend two 1-hour sessions of motivational interviewing over 2 consecutive weeks, followed by a third session 8 weeks later. The group assigned to treatment as usual will not partake in motivational interviewing, but will continue to receive their normal care. All participants will return to the study site for follow-up assessments, which will include measures of antidepressant adherence, at Months 2 and 5.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 50

Inclusion Criteria

Self-identifies as Hispanic
DSM-IV diagnosis of any unipolar depressive disorder (i.e., MDD, dysthymia, or depressive disorder not otherwise specified)
Currently taking antidepressant medication

Exclusion Criteria

Clinically significant suicidal ideation
DSM-IV diagnosis of any substance-related disorder, bipolar disorder, or psychotic disorder/features within 12 months prior to study entry
Unstable general medical condition

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
1	Motivational interviewing	Participants will receive motivational interviewing in addition to their antidepressant therapy
2	Treatment as usual	Participants will receive treatment as usual

Primary Outcome Measures

Name	Time	Method
Medication Adherence, as Measured by Electronic Pill Container	Measured immediately post-treatment and at Months 2 and 5 months follow-ups	Medication container caps (MEMS) recorded each instance where the antidepressant medication container was opened. An adherence index was derived the represented the percentage of days, within the medication period, where the container was opened.

Secondary Outcome Measures

Name	Time	Method
Treatment Retention	Measured at Month 5
Beck Depression Inventory-II (BDI-II)	Measured at Month 5	The BDI-II contains 21 questions, each answer being scored on a scale value of 0 to 3. 0-13: minimal depression; 14-19: mild depression; 20-28: moderate depression; and 29-63: severe depression. Higher total scores indicate more severe depressive symptoms.
Medication Attitudes	Measured at Month 5