Blue Care Network Best Practices
Antidepressant medication management
Patient education and follow-up yields successful medication compliance for patients with depression
Medication compliance is one of the biggest issues facing physicians who treat patients with depression. Babar Ahmad, M.D. of Mid Michigan Physicians in Lansing asserts that the doctor-patient relationship is critical to treating these patients. He has achieved a high compliance rate through patient education and thorough follow-up.
Dr. Ahmad is a believer in working together with the patient and getting patient buy-in before starting on antidepressants.
"I'm honest with my patients and I want the same from them," said Dr. Ahmad. "I don't have a cure for everything, but I promise to do my best. If I put someone on medication and they don't feel I'm helping them, they won't commit."
He says it's important to communicate expectations to patients. Dr. Ahmad makes patients aware that it may take two to four weeks for most antidepressants to take effect. "They also know that they have to notify me if they are thinking of stopping their medication," said Dr. Ahmad. "I tell patients I am their navigator. My job is to guide them and their job is to steer clear of the rocks." So patients know up front they are working with their doctor as part of a team.
Educating patients about the side effects of medications also helps boost compliance. "I review the side effects of the medications as much as I can," said Dr. Ahmad. "If they know my expectations and they know they are coming to see me in six weeks, they don't want to let me down."
Follow-up is important
Dr. Ahmad follows up with patients six to eight weeks after the initial prescription.
He also uses an electronic medical record for labs. "It helps us follow patients," he said. "It's easier to see if someone is not getting the follow-up he or she needs instead of waiting to get letters from the pharmacy."
Longer term follow-up is a natural extension of Dr. Ahmad's practice philosophy. "Many times if a patient is depressed, they have other medical issues, so I'm seeing them frequently," he said.
During follow-up visits, Dr. Ahmad may also change the dosing regimen if he and the patient decide together that doing so is going to help their outcomes. Dr. Ahmad discusses job performance, concentration and the patients' interests in things they enjoy to help gauge whether the medication is having its intended effect. "I talk to my patients about how they are feeling and we decide together. I never dictate to them what they should do," he said.
His availability to his patients also has a positive impact on treatment outcomes and medication compliance. Dr. Ahmad explains that his personal phone number is listed so patients can call him at any time. "When patients know the doctor is concerned and they can talk to me, that is their consolation. They may not call, but they know they can always reach me," he said.
Financial considerations are taken into account as well. Patients are more apt to stay on their medication if it's affordable, so Dr. Ahmad works with patients to make sure he prescribes medications that are covered by insurance. He favors generics and drugs that have been on the market a longer time and have proven their effectiveness.
Dr. Ahmad says his patients are all special. In dealing with depression, he notes, "With other organic disorders, you may not see much difference in four to six weeks. But with depression, you can see the difference. It's a privilege to help people and see the smiles on their faces."