Depression May Affect Adherence Among Diabetics

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.

Reference

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