Symptoms of depression and anxiety and adherence to antihypertensive medication
Open Access
- 1 April 2012
- journal article
- Published by Oxford University Press (OUP) in American Journal of Hypertension
- Vol. 25 (4), 505-511
- https://doi.org/10.1038/ajh.2011.256
Abstract
Nonadherence to drug treatment is a major contributor to antihypertensive treatment failure. Mood disorders could impair the patient's desire and ability to follow physician's recommendations. We evaluated the role of symptoms of depression and anxiety on adherence to antihypertensive drug treatment. We conducted a longitudinal cohort study in 20–70 years old patients starting antihypertensive drug treatment, without other chronic conditions, and not taking mood-modifying drugs. Severity of symptoms of depression and anxiety were evaluated at enrollment and 3, 6, 9, and 12 months of follow-up, using the Beck depression inventory-II (BDI-II) and the psychological general well-being index (PGWB), respectively. Treatment adherence was measured by pill count. Nonadherence was defined as taking <80% of the prescribed number of pills. Poisson regression was used to model the association of the exposures with adherence. We enrolled 178 patients (58% male; mean age: 50 years; 508 follow-up visits). The risk of nonadherence was 52.6% in 12 months (95% confidence interval (CI): 46.1, 59.1). After adjusting for other risk factors, individuals with at least mild depression (BDI-II ≥14) and those with at least mild anxiety (PGWB anxiety score <22) were 2.48 (95% CI: 1.47, 4.18) and 1.59 (95% CI: 0.99, 2.56) times more likely to become nonadherent in the following 3 months, respectively. Patients with at least mild anxiety and depression symptoms are at increased risk of becoming nonadherent to antihypertensive medication. Screening for depression and anxiety symptoms could be used to identify high-risk patients. Further evidence is needed to elucidate whether interventions targeting these conditions improve adherence.Keywords
This publication has 37 references indexed in Scilit:
- Adherence to Antihypertensive Medications and Cardiovascular Morbidity Among Newly Diagnosed Hypertensive PatientsCirculation, 2009
- Adherence to prescribed antihypertensive drug treatments: longitudinal study of electronically compiled dosing historiesBMJ, 2008
- Self-Efficacy Mediates the Relationship Between Depressive Symptoms and Medication Adherence Among Hypertensive African AmericansHealth Education & Behavior, 2006
- Depression in adults with type 2 diabetes: The role of adherence, body mass index, and self-efficacy.Health Psychology, 2005
- Effects of Noncardiovascular Comorbidities on Antihypertensive Use in Elderly HypertensivesHypertension, 2005
- Hypertension Treatment and Control in Five European Countries, Canada, and the United StatesHypertension, 2004
- Psychometric evaluation of the Beck Depression Inventory-II with primary care medical patients.Health Psychology, 2001
- Self-efficacy pathways to childhood depression.Journal of Personality and Social Psychology, 1999
- Subjective bias in reports of poor work adjustment in depressed patientsActa Psychiatrica Scandinavica, 1989
- The Effects of Antihypertensive Therapy on the Quality of LifeNew England Journal of Medicine, 1986