Depression May Affect Early, Long-Term Drug 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=4,018) 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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