Adult diabetes patients who don't understand basic health information are
less likely to continue taking newly prescribed antidepressants, a new study
This is an important issue because depression in adults with diabetes is
often chronic and may require long-term treatment with medication, the
The nearly 1 400 patients in the study were followed for 12 months after
being prescribed an antidepressant. Most of the patients filled the prescription
at least once, but 43% did not refill the prescription and nearly two-thirds had
stopped taking their antidepressant medication by the end of the study.
The investigators found that 72% of the patients struggled to understand
basic health instructions, which the study authors called "limited health
literacy." These patients were much less likely to keep taking their
antidepressants than those with good health literacy, the authors said in a news
release from Kaiser Permanente.
This difference was not explained by other factors known to be associated
with patients not taking prescribed medications, including age, race and
ethnicity, income, and level of English-language skills, according to the study,
which was published in the March issue of the Journal of General Internal
All about improvement
"The high rates of early discontinuation among adults with diabetes who had
any health literacy limitation suggest that few of these individuals received an
adequate course of antidepressant therapy," lead author Dr Amy Bauer, of the
University of Washington School of Medicine, said in the news release. "Getting
that sufficient treatment is critical in preventing relapse and recurrence of
"Physicians should be aware of this," Bauer added. "For antidepressant
treatment to succeed, patients with limited health literacy may require more
intensive counselling and clearer explanations about use of antidepressant
medications and closer follow-up."
Study senior author Andrew Karter, a research scientist at Kaiser Permanente,
said other studies have found that "those with health literacy limitations are
more likely to have poor control of their chronic medical conditions, such as
diabetes, congestive heart failure and HIV."
He added, however, that "this is the first study to examine the association
between health literacy and antidepressant adherence among patients with
diabetes. This type of research gives our health care systems important feedback
because, as providers, we often remain unsure whether the critical health
information we convey to our patients is fully understood."
The researchers said the new findings highlight the importance of efforts to
improve people's health literacy, simplify information about treatment options,
improve public understanding about depression treatment, and monitor whether
patients are taking their prescribed antidepressants.
The US National Institute of Mental Health has more about
diabetes and depression.