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. 2022 Dec 14;19(24):16788. doi: 10.3390/ijerph192416788
Block 1. Experience of medication management
1. What is your experience with managing depression (particularly, burden of treatment)?
2. In general, what attitude(s) do you face with depression and its management compared to other mental illnesses?
3. In your opinion, what aspects of depression present greater complexity or difficulty when treating patients?
Block 2. Depression treatment
1. In clinical practice, could it be the case that depression is not treated adequately? What factors can influence this?
2. Antidepressants: what factors do you consider when prescribing them?
3. Normally, do you prescribe one treatment or another depending on the severity of the depression?
4. Do you think that patients have enough information about the different treatment options?
Where do they get this information from?
Do you think it influences the expectations they have of the treatment?
5. How do you normally make decisions about treatment?
Do you apply a shared decision-making model in which the patient is informed of the therapeutic options and the treatment is agreed upon with him or her?
What do you think are the greatest difficulties in following this model in practice?
The advantages?
6. Do you usually apply motivational interviewing strategies in your clinical practice?
Do you find them useful?
What barriers and facilitators do you think there are to applying them in the consultation?
Block 3. Pharmacological adherence
1. Could you tell us about therapeutic adherence in depression from your own experience and professional career? (What is the situation we are in?)
2. What would be the main determinants of therapeutic adherence?
Its main modifiers? (For example, in relation to the disease, socio-demographic variables, preference for other types of treatment (psychotherapy, others, such as relaxation, bibliotherapy, music therapy, physical exercise, etc.).
3. From your experience, is it possible to draw an adherent and non-adherent patient profile? Please describe them.
4. From your own experience, do patients usually report aspects related to therapeutic non-adherence as a problem (adverse effects; difficulty keeping schedules; having to submit to restrictions, such as not consuming alcohol while taking the medication; cost; difficulty swallowing pills; etc.)?
Do they communicate these problems, or do they remain silent and hide them?
5. What do you consider to be the main barriers that patients encounter in complying with treatment?
The professionals?
6. Have you tried to overcome non-adherence in patients with depression/dysthymia in your clinical practice?
If the answer is affirmative,
What methods have you applied?
Which have been effective, and which have not?
What do you consider to be the barriers to the implementation of this type of method in the Spanish health system?
What conditions do you see as being necessary for the implementation of this type of method?
7. On the contrary, what facilitators might be useful for the implementation of this type of method in the Spanish health system?
8. In our project, we are going to evaluate a strategy consisting of the use of a mobile phone application and attention to a training program (series of telephone sessions (6–12) for fourteen weeks with the following content: education for depression, management of medication, behavioral activation, implemented by a psychologist) for the patient to improve therapeutic adherence. Do you think this could be useful?
If the answer is affirmative,
Would you consider suggesting an intervention strategy like this to your patients?
What if this strategy involved attending a four-hour training workshop spread over two sessions?
What are the reasons for considering or not considering such an intervention, in each case?
Would you like to add anything else that you consider important and that was not included in the interview?