Identifying Factors Influencing Medication Adherence in Patients With Major Depressive Disorder: A Qualitative Study

Abstract

The aim of this study was to identify the factors influencing medication adherence in patients with Major Depressive Disorder using a qualitative approach. This qualitative study employed thematic analysis. Data were collected through semi-structured interviews with 20 patients diagnosed with Major Depressive Disorder who were undergoing pharmacological treatment in psychiatric centers in Tehran. Participants were selected using purposive sampling, and interviews continued until theoretical saturation was achieved. Data were analyzed through open, axial, and selective coding using Nvivo software. The analysis yielded three main categories: individual factors, environmental and social factors, and medication-related characteristics. Subcategories under individual factors included attitudes toward medication, illness perception, internal motivation, and coping skills. Environmental and social factors encompassed family support, economic status, societal attitudes, and experiences with healthcare providers. Medication-related barriers and facilitators included side effects, onset time of medication efficacy, complexity of the medication regimen, and access to medication. The findings of this study suggest that medication adherence in patients with Major Depressive Disorder is shaped by an interplay of individual, social, and treatment-related factors. The results provide a basis for developing psychosocial interventions, enhancing patient education, strengthening family support systems, and improving the quality of pharmacological care.