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Adults With Diabetes And Limited Health Literacy Less Likely To Adhere To Prescribed Antidepressants

Starting Antidepressants (Wife/Girlfriend)Adult patients with diabetes who don't understand basic health information are significantly less likely to take newly prescribed antidepressant medication, according to a new Kaiser Permanente study in the Journal of General Internal Medicine.
In this study conducted by the Kaiser Permanente Division of Research and the University of Washington School of Medicine, 72 percent of the 1,366 study participants had limited health literacy, and had significantly poorer adherence to newly prescribed antidepressants, compared to patients with no limitations.
"Research shows 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," said Andrew Karter, PhD, research scientist at Kaiser Permanente and senior author on the study. "However, 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 Institute of Medicine defines health literacy as the capacity for patients to "obtain, process, and understand basic health information and services needed to make appropriate health decisions." Because nearly 90 percent of Americans have some difficulty using routine health information, the U.S. surgeon general has identified the improvement of health literacy as a national priority.
Adequate adherence for antidepressants is particularly important for patients with diabetes and other chronic medical conditions. Depression occurs twice as frequently among adults with diabetes compared to adults without diabetes, and has been associated with an increased risk of the serious diabetic complications, dementia and mortality.
In the study, health literacy was based on a self-reported scale in which participants with type 2 diabetes responded to three questions:

  • How often do you have problems learning about your medical condition because of difficulty understanding written information?
  • How confident are you filling out medical forms by yourself?
  • How often do you have someone like a family member, friend, hospital or clinic worker or caregiver, help you read health plan materials?
The study examined medication nonadherence during the 12 months after the initial antidepressant prescription, and researchers found that many patients failed to adhere to their treatment. Although most patients filled the prescription at least once, 43 percent failed to fill the prescription a second time, and nearly two-thirds had discontinued the antidepressant by the end of the 12-month period.
Poor adherence to antidepressant medications has been described previously, but what was not known is that those with health-literacy limitations were significantly less likely to take their antidepressant medications. In fact, diabetes patients with limited health literacy were much less likely to refill their antidepressant medications in a timely fashion than patients with no limitations. These patterns were not explained by other factors known to be associated with medication nonadherence, including age, race/ethnicity, English proficiency and income, which were accounted for in the study.
Depression in adults with diabetes is frequently chronic, suggesting the need for long-term antidepressant therapy. "The high rates of early discontinuation that were observed among adults with diabetes who had any health literacy limitation suggest that few of these individuals received an adequate course of antidepressant therapy. Getting that sufficient treatment is critical in preventing relapse and recurrence of depression," said lead author Amy Bauer, MD, of the University of Washington School of Medicine. "Physicians should be aware of this. For antidepressant treatment to succeed, patients with limited health literacy may require more intensive counseling and clearer explanations about use of antidepressant medications and closer follow-up."
The researchers said the study findings underscore the importance of national efforts to address healthy literacy, simplify health communications regarding treatment options, improve public understanding of the importance of depression treatment, and monitor antidepressant adherence.
Additional authors on the study include Wayne Katon, MD, University of Washington; Dean Schillinger, MD, University of California, San Francisco Division of General Internal Medicine; Melissa Parker, MS, Alyce Adams, PhD, and Howard H. Moffet, MPH, Kaiser Permanente Northern California Division of Research; and Nancy Adler, PhD, University of California, San Francisco Center for Health and Community.
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'Protecting' Psychiatric Medical Records Puts Patients At Risk Of Hospitalization 'Switch' Critical to Wound Healing Identified 1811 2013 4 Ways to Beat Back Pain 5 hour energy 500 calories A simple soliloquy a1c AA aarp ablum accessible wheelchair car accessible wheelchair vans acne acne light treatment acting insulin acu acupressure ADD addiction ADHD adolescent victims adults Adults With Diabetes And Limited Health Literacy Less Likely To Adhere To Prescribed Antidepressants advance advise advising afghanistan Aflac Age Matters in Weight Gain: aids airsoft album review Alcoholic Alcoholics Anonymous All IT Supported alltel alzheimers AM General American College of Gastroneterology American Diabetes Association American Express ami clubwear amiclubwear.com amputation android anger animis anniversary anti radiation cell phone technology antibody antidepressants not working anxiety app application apps arginine arthritis artificial artistic aspirin Assurance Wireless asteroid atherosclerotic lesions Atlanta alcohol rehab Atlanta drug abuse rehab centers Atlanta Drug Rehab Atlanta Drug Rehab Center attack Avengers back on track back to school backup bad habbits baking banana george Banana Power bariatric surgery Barrett's Esophagus Baton Rouge battle depression bayer bayer breeze2 Bayer Contour USB bb gun BBB BE beating depression beauty become motivated before i die behealthy24.com Being sick totally sucks beta cells big blue test big foot Biomedtrics biosensor bipolar Bipolar bipolar disorder Birdman Birdman or The Unexpected Virtue of Ignorance birth birth defects birthday bladder cancer blog blogging blood glucose blood glucose levels blood pressure blood sample blood sugar blood sugar level blood sugar levels blood sugar monitor blood sugars blue shield Bluetooth bmi Body By Vi 90 Day Challenge body mass index bogo bogo. buy one get one free books bottom belly bracelet Brain Discovery Could Help Schizophrenics Breaking News breast breast feed breast feeding breastfeed breastfeeding brew Broadway budget bug out bugs bullied bullying Bums burn calories buy Caffeine Vape Stix by Energy Shisha california California Pacific Medical Center call center caloric needs calorie versions cancer candychang.com Cannabidiol cannabis car car loan. car; car loan; payday; payday advance; sponsored blog; guest post; carats cardio cardiovasular disease care cause cctv security dvr cd review Celebration celiac cell phone change cheap eyeglasses cheap glasses cheap scrub cheap scrubs check into cash cheif chicago child childhood depression Childhood diabetes childhood obesity children cholesterol christmas chronic inflammatory disease chronic pain cigarette ciglites cigs clinical depression clothing coconut oil coffee coffee prevents diabetes cognitive cold colorectal cancer Comedy Central comfort food community compare computer Computer Services condos connections contour usb meter control cooking corn syrup cosmetics coupons couponten.com crafts creative outlook credit card cupcake cyber bullying daily caloric daily caloric intake dancing dark cloud david pulley Day 3 of taking Lexapro and Victoza day care daycare ddiabetes deals Death debate debit card debt decaffeinated coffee decreased gene activity deep breathing dementia Dental Work and Tooth Pain depressed Depressed Stroke Survivors May Face Triple the Risk of Death depression depression in preschoolers depression isn depression symptoms Despite Free Health Care developing diabetes development diabetes Diabetes / Diabetic News Diabetes + Depression = Increased Risk of Death diabetes exist diabetes foundation diabetes less diabetes management diabetes medication Diabetes Trials Worldwide Are Not Addressing Key Issues In Affected Populations diabetic diabetic alert dog diabetic cook book diabetic cure diabetic education videos diabetic epipen diabetic food log diabetic healing diabetic insulin diabetic logbook diabetic medical review diabetic research Diabetic Retinopathy diabetic shock diabetic software diabetic supplies diabetic. ebook diamonds diet digital camera digital logbook direct Direct Association Between Type 2 Diabetes And Obesity Found direct tv directionless dirve disability disabled disease disorders Disrupting Our Internal Clocks May Lead To A Complete Absence Of 24-Hour Bodily Rhythms And An Immediate Gain In Body Weight Ditto divorce lawyer diy mouse trap dlucose doctors donation doomsday Doughnuts down range Drexel University drinking drive drop out drug drug abuse drugs dry skin DSHS dvd e-cig e-cigarettes e-juice e-reader e-zines eastern medicine eating disorders ecigarettes Economics education Edward Norton effective treatments egg whites egg yolks electri vehicle electrical stimulation Electronic emergency emergency kit Emma Stone emotional employment empty nest EMR endocrine engraved medical id ereader ev everyone else eviction excess weight exercise exercise regularly exercise routines exterminators eye eye care eye disease eye glasses EyeBuyDirect eyebuydirect.com facebook fad diet fad diets family focused therapy Family Time fashion fatty acids favorite foods FDA feel fuller fire fish oil fitness Fitness Professionals Appreciate Online Continuing Education Options Fitness; Obesity; Diabetes; Molecular Biology; Mice; Biology flights florida Florida health kids program flu food Food and Dining food diary food network foods contain forgetfulness four more years free free android apps free diabetic wristband Free Stuff french fries fresh flowers fresh fruit Fresh Vending Machines fructose fructose corn syrup fruit full moon funeral Gadgets gangnam style Gastroesophageal gastroparesis GE X500 Power Series genes genes linked to bipolar GERD gestational diabetes Gestational Diabetes Patients Will Develop Type 2 Diabetes Give Aways giving glasses glooko glucagon Gluco(M) Glucofact glucose glucose levels glucose log glucose management glucose meter gluten free glycemic control glycemic foods glycemic index glycemic indexes godaddy google gout grain foods green tea group guest blog guest post hair loss handicap accessible vans handicap minivans handicap vans handicapped vans happy Happy Birthday Hello Cupcake It's Me happy birthday to me :) happy holidays Harvey Birdman hba1c health health benefits health care healthier fast food healthy healthy foods healthy lifestyle healthy snack hearing loss heart heart attack heart broken Heart Disease; Cholesterol; Stroke Prevention; Diseases and Conditions; Chronic Illness; Heart Disease; Cholesterol; Stroke Prevention; Diseases and Conditions; Chronic Illness; diabetes Heart Disease; Cholesterol; Stroke Prevention; Diseases and Conditions; Chronic Illness; stroke Heart Disease; Cholesterol; Stroke Prevention; Diseases and Conditions; Chronic Illness; Vioxx heart monitor heart on my sleeve heart problems heart rate heath and beauty hello hellocupcakeitsme.com help hemoglobin Her high blood sugar high school High-Fat Foods May Be A Factor In Glucose Control hiv hiv1 hiv2 hobbytron.com holiday holiday's home security alarms home testing Homeless Homeless Shelter Homer Simpson honda hospitalization Household Income Affects Chronic Disease Control In Kids Humalog Human IPSC Humor Humulin R U-500 hunger hungry hurt on the job hyperglycima hyperglycimic hypertension hypoglycemia hypoglycemic hypoglycemic episode iBGStar Blood Glucose Monitoring System Ice Cream Image improvement including mufa foods infection infested infographic information injury inspriation insulated bag Insulin insulin injections insulin patch insulin pump insulin shot record insurance claims internal medicine Interspecies Transplant investments ios ios 5 iphone iphone 4 its iTunes Iwerkz Foldable Bluetooth Keyboard Review Jenna Mables jewelry joann joann fabric and craft store joint pain Journal of Alzheimer's Disease juwait Keek kenguru ketoacidosis occurs kicking the habbit kid kidcare kids Killings kindle kindle fire kitchen counter kombucha Labor and Industry Lamp;I lantus Late-Life Depression lawyer learning issues legal help Lexapro LG Rumor libido life lifestyle changes light box lincoln Link Between Creativity and Mental Illness Confirmed in Large-Scale Swedish Study Lipohypertrophy living loan Lone Star College Shooting loneliness lose weight losing weight loss plan lost low blood sugar low glucose levels Low income cell phone low income glasses low t low testosterone lower glucose lowering lowering glucose levels Luminaze lung health lyrics lyrics of depression Mainframe Support makeup managing diabetes Manic marijuana market mary lambert Master Card maya angelou Maya Angelou dead at 86 me meal plan meal prepping meals require medflash media / television medicaid Medical medical condition medical help Medical Review Medical Studies medical studies. medicare medicare part d medication medicines meditation melody road memory loss men's health Mental Health mental health issues Menu menu options merry christmas metabolic syndrome metabolism metabolites metersync blue miami Michael Keaton microstimulator military minimum purchases mission d.a.d mission dad Mixed Results On Computer-based Support For Diabetes mobility money money saving moods motivation mourning movie review Movie Reviews music music thearpy musings/thoughts/ideas must have MV-1 n-3 Fatty Acids Nanoparticle Suspension and Ultrasound Deliver Insulin Without Regular Injections natural home remdies natural suppliments need needing help needles needy negative thoughts neil diamond Network/Community networking new app new baby New Jersey's Universtiy of Medicine and Dentistry new medication New smart contact lens could monitor glucose for diabetics Nick Jonas night lights nissan no insulin Nook Tablet BNTV400 Review north aferica nova nordisk Now that the holidays are over obama obama phone obama wins 2012 obese Obesity obituries OCD ODD Oil Pulling Olycap omega-3 onetouch online magazines online medical records optical zoom optical123.com Optimus ERM optogenetics oral health oral hiv test oral swab oraquick overcome depression Oxygen paid marketing pancreas parental depression parkinsons party passing Paula Deen pay attention payday payday advance paying kids to attend school pedometer personal food chart Personal Post pest pests photography pills ping plam beach county Plays poet port townsend positive thoughts Postpartum Depression pot prayer pre-owned pre-school pregnancies pregnancy prepper prepping preschool prescription president prevent complications prices processed foods product Product Review products Progress Project 1811 project rudolph proline promo codes promotional Promotions psoriasis Psy public health publich education purchas questioning quit smoking raisins reaching out real butter real-estate really scare rearrange recipes Record red meat red wine reefer reflux regenerate regular exercise rehab remodel research resistance resource resources retail therapy retinopathy revamp review Reviewing the Vapourlites Blueberry/Strawberry E Juice revitalift rich foods risk roller coaster russia rx s.a.d sadness safe sex safelink Safelink wireless sale salt Sandy Hooks Elementary School Schooting saving money savings scar school School Shooting schooling scrubs for cheap seasonal affective disorder Seattle self diagnosis self help self love self medicating senior resources seo sesame seed oil sex Shindigz Coupon Code Shootings shopping Short story shot record sick side-effects simple tips SIN TAX Site Review skin care skin tags skip meals skipping meals sleep sleep apnea smaller meals smart car smart cars smart phone smoker smokes smoking social media social security sodium software sore throat sores south beach south beach diet spiral notebook sponsored sponsored review sponsored; lawyer; family; legal; issues; sponsored/guest post spot removal. ssi Statin Labels stem cell stock pile stomach pain stoner stop smoking store stress stretch marks study submit submitted substitutions successfully lose weight sugar free sugar levels sugary foods suicidal thoughts suicide Supplementation Of Alternative Fuels Could Protect The Brain During Hypoglycemia support surgery survival systemic inflammation taboo tai chi take out tax tea tech teen teen mental health teens television temporary mood test animals test strips testicle testicular cancer testing testing supplies testosterone thanksgiving the learning company the lines project. #thelinesproject thearpy therapy thought Three Devastating Statistics of Diabetes Medical Malpractice title to write love on her arm tone Tosh.O toxins Tracfone trained professional transaction travel treatment trend diets tribute to my father triglycerides tsa tweets twitter twloha type 3 diabetes type-1 type-2 type-2 diabetes U.S. Medicare Part D Can't Explain North-South Disparities UK News ultra long acting UMDNJ underlying reasons Undiagnosed Pre-Diabetes Highly Prevalent in Early Alzheimer's Disease Study unhealthy unhealthy foods up and coming artist up and down upcoming holidays update uric acid usb value of a dollar vans for handicap vans for handicapped vans for wheel chairs mobility vans vans for wheenchairs vape vapor vapourlites vendor Veterans Day Video violation violence Visa Visiting Your Doctor Following ER Care For Chest Pain Reduces Risk Of Heart Attack vitamin d vitamin deficiency walking walking chart walnuts contain washington water waterski weed week in review Week of learning weigh yourself weighing yourself weight weight loss weight loss chart weight loss goals weight loss plan weight loss program weight loss success weight loss tips weight slowly what is it What Your Skin Says About Your Health wheel chair wheel chair vans wheelchair wheelchair vans where to buy cheap scrubs whipped butter winter blues womens health Work Out workman's compensation workout X-Men x500 xanax Xenotransplantation Young people with diabetes dying due to lack of adequate healthcare Yourtel youtube YouTube Internet Sensations Then and Now

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