Key result
Good adherence (>80%) to antidepressant therapy was associated with a significantly reduced risk of all-cause mortality (HR 0.86) compared to non-adherence in patients with ischemic heart disease.
Why the study?
Does adherence to antidepressant therapy reduce all-cause mortality in patients with ischaemic heart disease?
Cohort (n=63,437)
Does adherence to antidepressant therapy reduce all-cause mortality in patients with ischaemic heart disease?
Hazard Ratio: 0.86 (95% CI 0.82–0.9)
Absolute Event Rate: 22.1% vs 13.8%
Moderate to good adherence to antidepressant therapy is associated with a significant reduction in all-cause mortality among patients with ischemic heart disease compared to non-adherence.
Should not yet change IHD practice; leaves open whether adherence interventions improve survival.
BACKGROUND: The use of antidepressant drugs in patients with ischaemic heart disease (IHD) has been debated owing to scarcity of data and conflicting results regarding the effect of these drugs on mortality. AIMS: To evaluate the association between adherence to antidepressant therapy and all-cause mortality in a population-based cohort of patients with IHD. METHOD: A total of 63 437 patients with IHD who purchased antidepressants at least once during the years 2008-2011 were retrospectively followed for all-cause mortality over 4 years. Adherence was measured as a ratio between claimed and prescribed durations of medication and modelled as non-adherence (<20%), poor (20-50%), moderate (50-80%) and good (>80%). We used multivariable survival analyses adjusted for demographic and clinical variables that may affect mortality. RESULTS: The moderate and good adherence groups had significantly reduced adjusted mortality hazard ratios of 0.83 (95% CI 0.78-0.88) and 0.86 (95% CI 0.82-0.90) respectively, compared with the non-adherence group. CONCLUSIONS: Adherence to antidepressant pharmacotherapy is associated with reduced all-cause mortality in a population-based large sample cohort of patients with IHD. Physicians and health policy decision-makers should step up their efforts to sustain and enhance these patients' adherence to their antidepressant regimen.
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Krivoy et al. (2015) conducted a cohort in Ischaemic heart disease (n=63,437). Good adherence to antidepressant therapy (>80%) vs. Non-adherence (<20%) was evaluated on All-cause mortality (HR 0.86, 95% CI 0.82-0.90). Good adherence (>80%) to antidepressant therapy was associated with a significantly reduced risk of all-cause mortality (HR 0.86) compared to non-adherence in patients with ischemic heart disease.
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