Project 1: ADAPT: Assisting Depressed Adults in Primary-care Treatment

Steven Marcus, PhD, Mark Olfson, MD, Kevin Volpp, MD, PhD

Depression is one of the most common psychiatric disorders; each year, 7% of adults in the United States experience at least one major depressive episode. Continuous antidepressant treatment is considered an effective evidence-based practice, as it tends to improve symptoms of depression, quality of life, and social function, as well as reduce health care costs. However, widespread problems with antidepressant adherence currently undermine the effectiveness of this treatment. One cause of early discontinuation is that antidepressants have a delayed onset of action and do not offer prompt relief. As a result, the risk of non-adherence is especially great during the period before antidepressants have become fully effective.

ADAPT is a randomized controlled trial that will test ways to help people improve their health and manage their antidepressant medication. We will do this by examining whether we can leverage different decision-making biases to improve adherence to antidepressants in the first six weeks of treatment among adults newly diagnosed with depression. This study will utilize the Penn Way to Health platform, a NIH-funded software platform for collecting data and communicating with patients, as well as a wireless device that tracks daily medication adherence. If our main hypotheses are supported, the results will lay the foundation for a larger trial to examine downstream clinical outcomes, long term maintenance effects, and the role of habit formation.