Work

A cross-sectional study of the influence of patient experience and psychological contract on medication adherence in depressive patients

Year: 2026

Type: article

Abstract: Effective antidepressant treatment is one of the most important approaches for alleviating depressive symptoms and reducing the risk of suicide. Nevertheless, the high rates of relapse and disability associated with depression are largely due to patients' poor medication adherence. This study investigated the influence of patient experience and psychological contract on medication adherence of outpatients with depression and sought to identify critical factors that could improve medication adherence and provide effective recommendations for the healthcare system. A cross-sectional survey was conducted in Psychiatric Out-patient department of a tertiary general hospital. A total of 348 participants diagnosed with depression were surveyed by SERVQUAL scale, Psychological Contract Scale and Morisky Scale to assess patient experience, psychological contract and medication adherence, respectively. The mean scores of patient experience, psychological contract, and medication adherence were 7.12 ± 1.25, 3.93 ± 0.36, and 5.32 ± 2.41, respectively. Patient experience and its five dimensions were positively correlated with medication adherence ( P < 0.01). Although the psychological contract was not directly associated with medication adherence, it exerted an indirect effect through its influence on patient experience. Patient experience was positively associated with medication adherence among individuals with depression. Moreover, psychological contract exerted an indirect effect on medication adherence by influencing the quality of the patient experience. These findings highlight the importance of enhancing patient-centered service and fostering trust-based relationships to improve treatment adherence in depressive populations. • Poor medication adherence is a major barrier to effective depression treatment. • Patient experience is positively associated with medication adherence in depression. • Psychological contract indirectly affects adherence by influencing patient experience.

Source: Exploratory Research in Clinical and Social Pharmacy

DOI: 10.1016/j.rcsop.2026.100784