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? |
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Where do they get this information from? |
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Do you think it influences the expectations they have of the treatment? |
5. |
How do you normally make decisions about treatment? |
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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? |
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What do you think are the greatest difficulties in following this model in practice? |
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The advantages? |
6. |
Do you usually apply motivational interviewing strategies in your clinical practice? |
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Do you find them useful? |
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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? |
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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.)? |
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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? |
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The professionals? |
6. |
Have you tried to overcome non-adherence in patients with depression/dysthymia in your clinical practice? |
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If the answer is affirmative, |
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What methods have you applied? |
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Which have been effective, and which have not? |
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What do you consider to be the barriers to the implementation of this type of method in the Spanish health system? |
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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? |
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If the answer is affirmative, |
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Would you consider suggesting an intervention strategy like this to your patients? |
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What if this strategy involved attending a four-hour training workshop spread over two sessions? |
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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? |