Coronary artery diseaseEffects of Depression and Anxiety Improvement on Adherence to Medication and Health Behaviors in Recently Hospitalized Cardiac Patients
Section snippets
Methods
This was a secondary analysis from a prospective randomized trial (http://clinicaltrials.gov, identifier NCT00847132) of a 12-week collaborative care depression treatment program versus usual care for depressed patients admitted to inpatient cardiac units.9 All study procedures were approved by the hospital's institutional review board.
Eligible patients for the collaborative care study were admitted for ACS, decompensated heart failure, or arrhythmia to inpatient cardiac units at an urban
Results
One hundred seventy-five participants enrolled in the trial; 14 subjects (8.0%) died during the 6-month study period. Of the 161 surviving patients, 134 (83.2%) completed all portions of the 6-month follow-up evaluation and were included in the primary analysis. Of these 134 subjects, 70 (52.2%) were randomized to the collaborative care intervention and 64 (47.8%) to usual care. Baseline characteristics of these 134 subjects are listed in Table 1. There were no significant differences on any
Discussion
Our results are consistent with previous findings that depression is associated with impaired subsequent adherence behavior (e.g., medication adherence, heart-healthy diet) in cardiac patients.5, 15 However, to our knowledge, only 2 previous studies have assessed whether improvement of depression is associated with improved adherence to cardiac treatment.
First, a pair of reports by Rieckmann et al25, 26 from 1 study found that improvement of depression (assessed during hospitalization and 3
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2022, Preventive MedicineCitation Excerpt :The link between smoking cessation and depression is intricate. To disentangle this issue, previous studies investigated the impact of depression on smoking cessation, in both ACS patients (Kronish et al., 2006; Rocha et al., 2017; Bauer et al., 2012; Dawood et al., 2008; Perez et al., 2008; Thorndike et al., 2008; Thorndike and Rigotti, 2009) and non-ACS patients (Stepankova et al., 2017; Huffman et al., 2018; Morozova et al., 2015). Overall, these studies found that depression renders smoking cessation more difficult, and that those who are depressed are less likely to quit.
Depression/anxiety symptoms and self-reported difficulty managing medication regimen among community-dwelling older adults
2022, General Hospital PsychiatryCitation Excerpt :Among Medicare beneficiaries diagnosed with chronic obstructive pulmonary disease (COPD), depression was associated with decreased adherence to COPD maintenance medications [16]. Among depressed cardiac patients (mean age 61.5 ± 11.8), improvement in depressive symptoms was significantly and independently associated with self-reported adherence to medications and secondary prevention behaviors at 6-week, 12-week, and 6-month follow-ups, and improvement in anxiety symptoms was associated with improved adherence at 6 weeks [24]. More research is needed to examine associations between depression/anxiety and medication management difficulties among older adults.
Dr Huffman received Scientist Development Grant 0735530T from the American Heart Association.