April 10, 2014Journal of Clinical HypertensionOpen Access

Initial Persistence With Antihypertensive Therapies Is Associated With Depression Treatment Persistence, But Not Depression

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Hypertension (n=44167). Intervention: Antidepressant therapy vs. No antidepressant therapy or non-persistence. Primary outcome: Early nonpersistence to antihypertensive therapies (OR 0.64, 95% CI 0.42-0.96).

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Key result

Antidepressant persistence linked to ~36% lower odds of early antihypertensive nonpersistence in depressed patients.

OR 0.64
95% CI 0.42-0.96
n=44,167

Why the study?

Does treatment and persistence with antidepressant therapy improve early persistence to antihypertensive therapies in newly treated hypertension patients with comorbid depression?

Population

44,167 adults with hypertension who were new users of antihypertensive therapy in 2008 at Kaiser Permanente…

Comparison

Treatment for depression and 6-month persistence… vs No treatment or non-persistence with…

Design

Cohort

Follow-up

6 months

Authors

JSJulie A. SchmittdielKaiser Permanente WDWendy DyerNorthumbria University CUConnie S. UratsuKaiser Permanente

Discussion

Member takes

Implication

Should not yet change practice in comorbid hypertension and depression; leaves open causal effects on antihypertensive adherence.

Study Design

Type

Cohort (n=44,167)

Structured PICO

Does treatment and persistence with antidepressant therapy improve early persistence to antihypertensive therapies in newly treated hypertension patients with comorbid depression?

Population

44,167 adults (18 years and older) with hypertension who were new users of antihypertensive therapy in 2008 at Kaiser Permanente Northern California, including a subset of 1,484 patients with clinical depression in the 12 months prior.

Intervention

Treatment for depression and 6-month persistence with antidepressant therapy

Comparator

No treatment or non-persistence with antidepressant therapy

Outcome

Early nonpersistence to antihypertensive therapies (defined as failing to refill the first prescription within 90 days after the end of the first fill days' supply)

Main Result

Effect estimate: OR 0.64 (95% CI 0.42-0.96)

In patients with comorbid hypertension and depression, persistence with antidepressant therapy is associated with better adherence to newly initiated antihypertensive medications.

Cite This Study

Schmittdiel et al. (2014) conducted a cohort in Hypertension (n=44,167). Antidepressant therapy vs. No antidepressant therapy or non-persistence was evaluated on Early nonpersistence to antihypertensive therapies (OR 0.64, 95% CI 0.42-0.96). Persistence with antidepressant therapy in hypertensive patients with depression was associated with lower odds of early nonpersistence to antihypertensive medications (OR 0.64; 95% CI 0.42-0.96).

synapsesocial.com/papers/6a0bc28c4607a9c6e995d653 https://doi.org/10.1111/jch.12300

Topics

Hypertension management

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Initial Persistence With Antihypertensive Therapies Is Associated With Depression Treatment Persistence, But Not Depression

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Initial Persistence With Antihypertensive Therapies Is Associated With Depression Treatment Persistence, But Not Depression

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider