| This study prospectively investigated the role of provider collaboration in antidepressant adherence among 48 depressed outpatients beginning treatment (Mean age = 41.4, SD = 12.6). The hypotheses tested in this study were based primarily on principles of interpersonal influence, and included: (a) higher patient-rated collaboration would predict greater adherence at 3, 6, 9, and 12 weeks post-baseline; (b) patient reactance would moderate the collaboration-adherence relationship; (c) and patient-rated provider liking, satisfaction with, and commitment to treatment would each mediate the collaboration-adherence relationship. Predictors were measured via questionnaires following the initiation of antidepressant treatment; adherence was assessed during telephone interviews. Evidence was found to support hypotheses (a) and (b), and satisfaction was a mediator in (c), but only at three weeks post-baseline in all cases. The interaction observed in (b) was such that higher levels of collaboration were associated with greater adherence among patients higher in reactance and lower adherence in less reactant patients. This study suggests that the examination of process variables in pharmacotherapy for MDD is important in predicting adherence, and it challenges the advocacy of more collaboration in antidepressant treatment as a general strategy. |
