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Compliance With Anti-Depressant Medication Among Prison Inmates With Depressive Disorders

NCJ Number
Date Published
19 pages
Publication Series
This study assessed the correlates of anti-depressant medication compliance among Texas prison inmates.
Poor compliance with prescribed anti-depressant regimens may undermine the medication's effectiveness, thereby increasing morbidity and its attendant costs. Improving medication compliance, therefore, is integral to improving the overall effectiveness and cost-efficiency of mental health care in correctional settings. The sample of the current study consisted of 5,305 Texas inmates who had been diagnosed with one of three depressive disorders: major depression, dysthymia, and bipolar disorder. The primary outcome measure analyzed was anti-depressant medication compliance. An institution-wide medical information system not only provided information on medication compliance but also on medical conditions and sociodemographic factors. Two broad classes of anti-depressant medication were examined for the study: TCA's (tricyclic antidepressants) and SSRI's (selective serotonin re-uptake inhibitors). Medication compliance was calculated by dividing the number of doses taken by the number of doses prescribed during the study period. The study found that inmates treated with SSRI's did not exhibit improved medication compliance compared to those treated with TCA's. In fact, among inmates with all depressive disorders and bipolar disorders, those treated with TCA's exhibited greater compliance, even when adjusting for sociodemographic factors; moreover, among inmates with depressive disorders, male gender, Black race, and older age were positively associated with medication compliance scores. Some investigators have argued that the more expensive SSRI's (compared with TCA's) would be more effective and cost-efficient due to their improvements in patient compliance; the current study found no such evidence. The sociodemographic findings suggest that correctional administrators may wish to target younger inmates and females with interventions to improve medication compliance. 3 tables and 25 references

Date Published: January 1, 1999