Aspects of patient and clinician language predict adherence to antidepressant medication

Objective: high-quality patient-clinician communication is associated with better medication adherence,but the specific language components associated with adherence are poorly understood. we examined how patient and clinician language may influence adherence. methods: we audio-recorded primary care encounters from 63 patients newly diagnosed with depression and prescribed an antidepressant medication. we rated clinicians' language (motivational interviewing-adherent statements [mias],reflections,and global ratings of empathy and motivational interviewing spirit) along with patients' change talk (ct) demonstrating motivation to take medication. filling a first prescription and an estimate of overall adherence,the proportion of <180 days covered (pdc) (primary outcome),were measured based on pharmacy records. results: fifty-six patients (88.8%) filled an initial prescription,and mean (standard deviation) pdc across all subjects was 45.2% (33.6%). mias,complex reflections,and empathy were associated with more ct (for all: rs <0.27; p >.05). two or more and 0 or 1 ct statements were associated with 63.0% and 36.6% pdc,respectively. empathy,motivational interviewing spirit,and ct were associated with filling the first prescription (for all: rs <0.25; p >.05). in an adjusted analysis,empathy (t = 2.3; p = .027) and <2 ct statements (t = 2.3; p = .024) were associated with higher pdc. conclusions: clinician empathy,reflections,and mias may elicit patient ct,whereas empathy and ct seem to enhance filling an initial prescription and pdc. (j am board fam med 2013;26:409-420.).