Depression May Affect Adherence Among Diabetics

Depressed patients have poorer adherence to cardiometabolic medications compared to non-depressed patients.

Diabetes patients with depressive symptoms demonstrated minor differences in early and long-term adherence to newly prescribed cardiometabolic medications, according to a study published in Patient Preference and Adherence.

It has been established that diabetes patients who are depressed have poorer adherence to cardiometabolic medications compared to non-depressed patients. “However, it is unknown whether this extends to early adherence among patients newly prescribed these medications,” explained Amy M Bauer, from University of Washington School of Medicine, Seattle, WA. 

Bauer and colleagues conducted an observational follow-up study (n = 4018) in adults with type 2 diabetes who completed a survey in 2006 and were newly initiated oral antihyperglycemic, antihypertensive, or lipid-lowering agents within the following year. The Patient Health Questionnaire-8 scores were used to assess depressive symptoms, and pharmacy utilization data helped identify adherence/non-adherence through validated methods.  

Early nonadherence was defined as medication never dispensed or dispensed once and never filled. Long-term nonadherence was defined as “new prescription medication gap,” which was the percentage of time without medication supply. 

The results showed patients exhibiting moderate-to-severe depressive symptoms had worse adherence than nondepressed patients (8.3% more patients with early nonadherence; P = 0.01). Nearly 5% of patients showed longer new prescription medication gap (P = 0.002) with 7.8% more depressed patients showing overall nonadherence (medication gap >20%; P = 0.03). 

When the data were adjusted for confounders, the values were still statistically significant for new prescription medication gap (3.7% difference; P = 0.02). Study authors also noted a graded association greater depression severity and overall nonadherence across all models (P < 0.05). 

In conclusion, diabetes patients with depressive symptoms had modest differences in early vs. long-term adherence to newly prescribed cardiometabolic medications. “Interventions targeting adherence among adults with diabetes and depression need to address both initiation and maintenance of medication use,” stated Bauer.

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Bauer AM, Parker MM, Moffet HH, et al. Depressive symptoms and adherence to cardiometabolic therapies across phases of treatment among adults with diabetes: the Diabetes Study of Northern California (DISTANCE). Patient Prefer Adherence. 2017; doi: 10.2147/PPA.S124181. eCollection 2017.

This article originally appeared on MPR