Association Between Depressive and Anxiety Disorders and Adherence to Antihypertensive Medication in Community-Living Elderly Adults
ABSTRACT OBJECTIVES: To identify the determinants of antihypertensive medication adherence in community-living elderly adults. DESIGN: Longitudinal observational study. SETTING: Population-based health survey in the province of Quebec, Canada. PARTICIPANTS: Data from a representative sample (N = 2,811) of community-dwelling adults in Quebec aged 65 and older participating in the Étude sur la Santé des Aînés study. The final study sample analyzed consisted of 926 participants taking antihypertensive drugs during the 2 years of the study. MEASUREMENTS: Adherence to antihypertensive medication was measured using days of supply obtained during a specified time period. Depression and anxiety disorders were assessed using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, and physical health status was measured using the Charlson Comorbidity Index. Other factors considered were age, education, marital status, annual family income, and number of antihypertensive drugs that participants used. RESULTS: Mean antihypertensive proportion (percentage) of days supplied in was 92.5% in Year 1 and 59.4% in Year 2. The presence of depression and anxiety disorders and the number of antihypertensive medications significantly predicted medication adherence. The sex by depression and anxiety disorders interaction term was significant. CONCLUSION: Adherence to antihypertensive medication was significantly associated with depression and anxiety disorders in men but not women. The treatment of depression and anxiety disorders in individuals with hypertension may be helpful in improving medication adherence rates and healthcare outcomes.
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Article: Medication adherence in the elderly[Show abstract] [Hide abstract]
ABSTRACT: Medication adherence is a crucial component in the treatment of chronic diseases. In the elderly, cli- nicians are faced with a unique set of problems associated with adherence that they may not have been adequately trained for. In this paper, we demonstrate the importance of medication adherence in the elderly through a case study. The different factors affecting medication adherence in the elderly are highlighted: patient, medication, health care providers, health care system, and socioeconomic factors. Lastly, we have proposed various ways to address these factors. In doing so, clinicians can better un- derstand the problems that the elderly face, thus achieving better therapeutic outcomes.
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ABSTRACT: Background. Hepatitis C virus (HCV) infection is associated with clinical depression,a condition that is aggravated on interferon-based therapy. In HCV infection, men often appear more resilient to depression than women. However, men are subject to depression in diseases that tend to be comorbid in HCV-infected. Aim. This study examined whether HCV-infected men with baseline comorbidities were more or less susceptible to depression prior to and on treatment. Methods. Patients with chronic HCV infection preparing to begin treatment participated (n = 37). The presence of baseline comorbidities was determined by pretreatment medication regimes. Depression was measured by the Beck Depression Inventory prior to and following 2, 4, 8, and 12 weeks of interferon therapy. Results. At baseline, cohorts with (n = 16) and without (n = 21) comorbidities had equivocal demographics and infection characteristics. Comorbidities did not associate with baseline depression. However, on treatment, men with baseline comorbidities demonstrated an elevated risk for the onset of de novo depression (odds ratio = 19.25; confidence interval = 1.41, 582.14; p = .008). This was not observed for women. Baseline comorbidities did not alter the need for treatment discontinuations or the ability to achieve a sustained viral response. Conclusion. The results of this study suggest that baseline comorbidities render men more susceptible to interferon treatment-induced depression.American journal of men's health 02/2014; DOI:10.1177/1557988314521231 · 1.15 Impact Factor
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ABSTRACT: Recent guidelines on cardiovascular disease prevention advocate the importance of psychological risk factors, as they contribute to the risk of developing cardiovascular disease. However, most previous research on psychological distress and cardiovascular factors has focused on selected populations with cardiovascular disease. The primary aim was to determine the prevalence of depression, anxiety, and Type D personality in elderly primary care patients with hypertension. Secondary aim was to examine the relation between elevated systolic blood pressure and depression, anxiety, and Type D personality. A cross-sectional study in primary care practices located in the south of the Netherlands. Primary care hypertension patients (N = 605), between 60 and 85 years (45 % men, mean age = 70 ± 6.6), were recruited for this study. All patients underwent a structured interview including validated self-report questionnaires to assess depression (PHQ-9), anxiety (GAD-7), and Type D personality (DS14) as well as blood pressure assessment. Depression was prevalent in 5 %, anxiety in 5 %, and Type D personality in 8 %. None of the distress measures were associated with elevated systolic blood pressure of >160 mmHg (all p-values >0.05). This study showed no relation between psychological distress and elevated systolic blood pressure in elderly primary care patients with hypertension.Netherlands heart journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation 12/2013; 22(2). DOI:10.1007/s12471-013-0502-z · 2.26 Impact Factor