MONTREAL — Hypertensive patients who have depression are less likely to stick to their therapy regimen than are those without, or in remission from, depression, according to a study of 161 patients.
“This suggests that any change in depressive symptomatology over time can affect medication adherence and may be clinically important,” Sara Gallagher said at the annual meeting of the Society of Behavioral Medicine.
Her study was embedded in a randomized, controlled trial that tested the effect of a motivational interviewing on medication adherence. It involved hypertensive African Americans (mean age 54; 87% women) who were followed in primary care practice.
Depressive symptomatology was assessed at baseline and at 6 and 12 months with the Center for Epidemiologic Studies-Depression Scale. Forty-four percent were classified as nondepressed, and 19% were considered depressed. Thirty-seven percent were classified as remittent, having progressed from depressed to nondepressed over the course of the study, said Ms. Gallagher of New York (N.Y.) University.
Medication adherence was assessed at baseline and at 12 months with the self-reported Morisky scale. At baseline, 64% reported nonadherence. This dropped to 48% by study's end.
A multivariate analysis showed that depressive symptoms were associated with medication nonadherence, Ms. Gallagher said. Among the depressed patients, 34% reported adherence at 12 months, compared with 66% in the nondepressed group and 47% in the remittent group.
The finding that a remittence of symptoms can result in improved adherence suggests a benefit to addressing patient depression in this context, Ms. Gallagher said.