2.50
Hdl Handle:
http://hdl.handle.net/10755/211540
Type:
Research Study
Title:
MEDICATION ADHERENECE IN HEART FAILURE PATIENTS: DEPRESSION AS A DETERMINANT
Abstract:
Purpose: The purpose of the study was to explore the association between depression and medication adherence in HF patients. The specific question asked was whether depression predicts self-reported and objectively-measured medication adherence in the same manner. Background: Self-reported medication adherence is assumed to over-estimate adherence because of social desirability. A recent study suggested that depressed heart failure (HF) patients under-estimate rather than over-estimate their medication adherence. As many as 20% to 60% of HF patients experience depression. If depressed HF patients are under-estimating their medication adherence, this has important implications for research and clinical practice. Method: Adults with Stage C HF (N=237; mean age 62 + 12; 64% male, 61% White) were enrolled from 3 sites in the northeastern U.S. into a prospective descriptive study. Self-reported medication adherence was obtained using the Basel Assessment of Adherence Scale (BAAS); objective data on medication adherence were collected using the electronic Medication Event Monitoring System (MEMS). Depression was measured with the Patient Health Questionnaire (PHQ-9). Using data collected at 6 months, chi-square analysis and General Linear Modeling (GLM) were used to explore the influence of depression on self-reported and objectively measured medication adherence, controlling for age, gender, race, and data collection site as covariates. Results: At 6 months, 34.3% of the sample had at least mild depression (PHQ-9 ≥5). Self-reported nonadherence was higher in the depressed sample compared to the non-depressed subjects (74.7% vs. 25.3%, p=.008). Total PHQ-9 score was a significant predictor of self-reported medication nonadherence (p=.012). Objective medication nonadherence was not significantly different in the depressed and non-depressed subjects (60.2% vs. 39.8%, p=.53). Depression was not a significant predictor of objectively measured medication nonadherence (p=.56). Conclusion: Depressed HF patients over-reported medication nonadherence even though objectively measured nonadherence was no different based on depression scores. Depression is associated with negative thoughts and low self-esteem, which may explain over-reporting of nonadherence in this sample. This work was funded by a grant from the National Heart, Lung & Blood Institute (RO1 HL084394-01A1) and by the Philadelphia Veterans Affairs Medical Center, VISN 4 Mental Illness Research, Education, and Clinical Center (MIREC).
Keywords:
Depression; Medication adherence
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
4608
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleMEDICATION ADHERENECE IN HEART FAILURE PATIENTS: DEPRESSION AS A DETERMINANTen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211540-
dc.description.abstractPurpose: The purpose of the study was to explore the association between depression and medication adherence in HF patients. The specific question asked was whether depression predicts self-reported and objectively-measured medication adherence in the same manner. Background: Self-reported medication adherence is assumed to over-estimate adherence because of social desirability. A recent study suggested that depressed heart failure (HF) patients under-estimate rather than over-estimate their medication adherence. As many as 20% to 60% of HF patients experience depression. If depressed HF patients are under-estimating their medication adherence, this has important implications for research and clinical practice. Method: Adults with Stage C HF (N=237; mean age 62 + 12; 64% male, 61% White) were enrolled from 3 sites in the northeastern U.S. into a prospective descriptive study. Self-reported medication adherence was obtained using the Basel Assessment of Adherence Scale (BAAS); objective data on medication adherence were collected using the electronic Medication Event Monitoring System (MEMS). Depression was measured with the Patient Health Questionnaire (PHQ-9). Using data collected at 6 months, chi-square analysis and General Linear Modeling (GLM) were used to explore the influence of depression on self-reported and objectively measured medication adherence, controlling for age, gender, race, and data collection site as covariates. Results: At 6 months, 34.3% of the sample had at least mild depression (PHQ-9 ≥5). Self-reported nonadherence was higher in the depressed sample compared to the non-depressed subjects (74.7% vs. 25.3%, p=.008). Total PHQ-9 score was a significant predictor of self-reported medication nonadherence (p=.012). Objective medication nonadherence was not significantly different in the depressed and non-depressed subjects (60.2% vs. 39.8%, p=.53). Depression was not a significant predictor of objectively measured medication nonadherence (p=.56). Conclusion: Depressed HF patients over-reported medication nonadherence even though objectively measured nonadherence was no different based on depression scores. Depression is associated with negative thoughts and low self-esteem, which may explain over-reporting of nonadherence in this sample. This work was funded by a grant from the National Heart, Lung & Blood Institute (RO1 HL084394-01A1) and by the Philadelphia Veterans Affairs Medical Center, VISN 4 Mental Illness Research, Education, and Clinical Center (MIREC).en_GB
dc.subjectDepressionen_GB
dc.subjectMedication adherenceen_GB
dc.date.available2012-02-20T12:01:08Z-
dc.date.issued2012-02-20T12:01:08Z-
dc.date.accessioned2012-02-20T12:01:08Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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