Assessment of pharmacological strategies for management of major depressive disorder and their costs after an inadequate response to first-line antidepressant treatment in primary care

Table 4 Relationship between compliance, persistence, and referrals to mental health care. Annual follow-up

Groups	Inadequate response	Remission	Total	P value
Number of patients, %	N = 965 (42.7%)	N = 1,295 (57.3%)	N = 2,260	P value
Treatment compliance
At 6 months	66.2%	67.9%	67.1%	0.033
At 12 months	65.1%	67.7%	66.6%	<0.001
Treatment persistence
At 6 months	46.5%	64.4%	53.9%	<0.001
At 12 months	31.8%	53.2%	42.7%	<0.001
Referrals to psychiatry
Mean referrals (per patient)	0.2 (0.4)	0.1 (0.4)	0.2 (0.4)	0.005
At 6 months (N = 293)	4.8%	8.2%	13.1%	<0.001
At 12 months (N = 413)	21.6%	16.8%	18.8%	<0.001
Time to referral, months	6.4 (4.0)	3.4 (2.4)	4.8 (3.6)	<0.001
Reasons for referral
Disease severity (N = 174)	41.2%	43.0%	42.1%	<0.001
No response to treatment (N = 196)	53.8%	41.6%	47.5%	<0.001
Patient decision (N = 43)	5.0%	15.4%	10.4%	<0.001

Values given as mean (standard deviation). Treatment compliance: ratio between the numbers of tablets dispensed/prescribed. Persistence: median time without discontinuation of initial treatment or without switch to another medication, at least 8 weeks after initial prescription.

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