Objective  To explore the rate of medication compliance and its influencing factors in patients with depression by Meta-analysis.

Methods  The relevant literature on the influencing factors of medication compliance of patients with depression were searched in PubMed, Web of Science, Embase, the Cochrane Library, Scopus, Ovid, CBM, CNKI, VIP and WanFang Data. The search period was from the establishment of the databases to September 2023. The literature was screened independently by two researchers, and data extraction and quality evaluation were carried out for the included literature. Stata 17.0 software was used for analysis.

Results  30 articles were included, with a total sample size of 550 115 cases, among which 230 669 patients had medication compliance. The medication compliance rate of depression patients was 53.8%[95%CI(45.1%, 62.5%), P<0.001]. Subgroup analysis showed that the compliance rate of domestic patients (48%) was lower than that of foreign patients (60%). The rate of medication compliance increased from 2004 to 2018, and decreased after 2019. Patients from outpatient clinics had a lower adherence rate (50%) than patients from other sources; the patient compliance rate (60%) measured by Beliefs about Medical Questionnaire (BMQ) was higher than other types of scales. Patients using Chinese classification and diagnosis criteria for mental disorders (3rd Edition) (CCMD-3) had the lowest rate of medication compliance (23%). The results of Meta-analysis showed that monthly income level [OR=2.45, 95%CI(0.85, 4.61), P=0.046], working status [OR=2.35, 95%CI(1.31, 4.19), P=0.004], social support level [OR=2.82, 95%CI(1.24, 6.39), P=0.013], stigma [OR=3.48, 95%CI(1.84, 6.56), P<0.001], personality traits [OR=1.43, 95%CI(0.68, 3.01), P=0.001], attitude towards medical staff [OR=7.60, 95%CI(3.64, 15.82), P<0.001], anxiety [OR=1.60, 95%CI(1.24, 2.07), P<0.001], disease cognition [OR=5.53, 95%CI(2.41, 12.67), P<0.001] and drug types [OR=0.49, 95%CI(0.32, 0.76), P=0.001] were influencing factors for medication compliance in patients with depression.

Conclusion  The existing evidence showed that the medication compliance rate of depression patients was low. There were significant differences in the medication compliance rates of patients at home and abroad, in different time periods, from different sources, using different measuring tools and diagnostic criteria. General factors (monthly income level, working status), psychosocial factors (social support level, stigma, personality traits, attitude toward medical personnel), disease factors (anxiety, disease cognition) and drug types were the main influencing factors of medication compliance of patients with depression. In the future, personalized intervention measures should be implemented based on relevant factors to improve medication compliance of patients and improve the prognosis of depression.

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