More Evidence of the Association of Depression With Adherence to Medical Therapies in Coronary Heart Disease

Elsewhere in JAMA Network Open, Lapa and colleagues 1 have provided an interesting report of the largest study of which I am aware that assesses adherence to cardiac medication regimens in patients with depression and coronary heart disease (CHD). 1 The retrospective study included 124 443 patients who were followed for a year after receiving percutaneous coronary intervention (PCI).Nearly 17% of these patients had a documented diagnosis of a depressive disorder.The authors chose to evaluate adherence to 4 guideline-directed medical therapies for these patients: antiplatelet agents, β-blockers, statins, and renin-angiotensin-aldosterone system inhibitors.As a result of the large sample size and the availability of medical records with relevant information, the authors were able to compare rates of adherence between patients with and without depression in multivariable-adjusted regression models that included many of the major potential confounders.Adherence to all the medications except for renin-angiotensin-aldosterone system inhibitors was significantly lower in the group with depression than in the group without.The limitations of the study are acknowledged and discussed by the authors.Despite these limitations, the study offers strong support for routine screening and assessment of depression in patients with CHD to identify those who are likely not to fully adhere to the medical regimen.