Medication Adherence among Thai Adolescents with Major Depressive Disorder
thesis
posted on 2024-08-01, 00:00authored bySuchanart Inwanna
Purpose: Major depressive disorder (MDD) is common in adolescents worldwide, and often requires regular taking of medication. In Thailand, medication adherence rates among adolescents with MDD are low. International studies have identified factors influencing medication adherence, including family involvement, but none have focused on Thai adolescents. Therefore, this study used the Individual and Family Self-management Theory (IFSMT) to identify factors associated with medication adherence among Thai adolescents with MDD.
Methods: A cross-sectional, quantitative design was used to examine relationships between key IFSMT factors and medication adherence behaviors among Thai adolescents and their legal guardians. A survey of 146 adolescent-legal guardian dyads was conducted using purposive sampling at two psychiatric outpatient clinics in Thailand. Written informed assent and consent were obtained before survey completion.
Results: Adolescent participants’ (n = 146) mean age was 16.16 years (SD = 1.58), with 71.92% being female and 62.33% being high school students. Legal guardian participants’ (n = 146) mean age was 48.62 years (SD = 6.73), 77.40% were female, and 90.41% were parents of adolescent participants. About 80% of adolescents exhibited low medication adherence. The study identified three significant context factors influencing medication adherence: experiencing antidepressant side effects, adolescents’ medication preferences, and their legal guardians’ medication preferences. Self-management process factors significantly associated with medication adherence included adolescents’ beliefs about the need for medication and medication concerns, legal guardians’ beliefs about the need for medication, and adolescents’ perceived levels of social support. Hierarchical multiple regression revealed that significant context factors alone explained 14.1% of the variance in medication adherence (Model 1). Adding self-management process factors (Model 2) explained 32.5% of the variance, increasing the explained variance by 18.4%. Consequently, self-management process factors in Model 2 accounted for most of the effects of the context factors in Model 1.
Conclusion: To improve medication adherence among Thai adolescents with MDD, clinicians should assess their and their legal guardians’ knowledge of antidepressant side effects, treatment preferences, medication beliefs, and social support. These insights can inform development of effective interventions. Future research in this area should use longitudinal approaches and include objective measures along with self-reports.
History
Advisor
Sarah Abboud
Department
Human Development Nursing Science
Degree Grantor
University of Illinois Chicago
Degree Level
Doctoral
Degree name
Doctor of Philosophy
Committee Member
Catherine Vincent
Cynthia Handrup
Alana Steffen
Alicia K. Matthews
Masatha Thongpan