| 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? | ||