Key Points
- To evaluate whether current major depression is associated with medication nonadherence among outpatients with stable coronary heart disease.
- Cross-sectional study of 940 outpatients with stable coronary heart disease.
- Major depression was assessed using the Diagnostic Interview Schedule, and medication adherence was measured via self-report.
- Multivariable logistic regression models adjusted for age, ethnicity, education, social support, and cardiac disease severity.
- Major depression was present in 22% (204/940) of participants, with 14% (28/204) of depressed vs 5% (40/736) of nondepressed participants reporting not taking medications as prescribed (OR, 2.8; 95% CI, 1.7-4.7; P < .001).
- Depressed participants were more likely to forget medications (18% vs 9%; OR, 2.4; 95% CI, 1.6-3.8; P < .001) and deliberately skip doses (9% vs 4%; OR, 2.2; 95% CI, 1.2-4.2; P = .01).
- The association between major depression and nonadherence persisted after multivariable adjustment for demographic and disease severity factors (adjusted OR, 2.2; 95% CI, 1.2-3.9; P = .009).
Structured PICO
Does major depression reduce medication adherence in outpatients with stable coronary heart disease?
PPopulation940 outpatients with stable coronary heart disease (CHD)
IInterventionCurrent major depression (assessed using the Diagnostic Interview Schedule)
CComparatorNo major depression (nondepressed participants)
OOutcomeSelf-reported medication adherence (not taking medications as prescribed)patient reported
Major depression is significantly associated with self-reported medication nonadherence in outpatients with stable coronary heart disease, highlighting a potential mechanism for adverse cardiovascular outcomes in this population.