Adherence to self-care interventions for depression or anxiety: A systematic review

The objective of this study was to synthesise and describe adherence to intervention in published studies of supported self-care for depression or anxiety, and to identify participant characteristics associated with higher adherence. We identified 40 studies of supported self-care interventions for depression and anxiety, of which 22 (55%) reported any measure of adherence to the intervention. Among these 22 studies, 18 (82%) reported the percentage of participants completing the entire self-care tool (20%–93%; Mean = 66%, SD 17), 13 studies reported the amount of self-care tools completed by the average participant (50.6%–96.4%; Mean = 80%, SD 11.6). Four studies (18%) reported the frequency of contacts with the self-care guide. Three (14%) studies reported participant characteristics associated with adherence. Overall, reported adherence levels to supported self-care interventions for depression and anxiety indicate a significant amount of patient involvement in these interventions. Routine reporting of adherence will improve our understanding of adherence to supported self-care interventions, and will allow researchers to link adherence with intervention outcome

Adherence to a Telephone-Supported Depression Self-Care Intervention for Adults With Chronic Physical Illnesses

We assessed adherence to and predictors of two components of a telephone-supported self-care intervention for depression among primary care adults aged 40 and above with chronic physical illnesses and comorbid depressive symptoms. Participants received a “toolkit” containing six self-care tools. Trained lay self-care “coaches” negotiated a contact schedule of up to weekly contacts. Study outcomes were levels of completion of the self-care tool and the coach contacts at the 2-month follow-up. Coaches reported the number of completed contacts. In all, 57 of 63 participants completed the 2-month follow-up. Of these, 67% completed at least 1 tool; the mean number of coach contacts was 5.7 (SD = 2.4) of a possible 9 contacts (63% adherence). Higher disease comorbidity and lower initial depression severity independently predicted better tool adherence. Findings suggest that people with chronic physical illnesses can achieve acceptable levels of adherence to a depression self-care intervention similar to those reported for other populations