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Journal of General Internal Medicine
Erschienen in: Journal of General Internal Medicine 10/2011

01.10.2011 | Reviews

Depression and Medication Adherence in the Treatment of Chronic Diseases in the United States: A Meta-Analysis

verfasst von: Jerry L. Grenard, PhD, Brett A. Munjas, MS, John L. Adams, PhD, Marika Suttorp, MS, Margaret Maglione, MPP, Elizabeth A. McGlynn, PhD, Walid F. Gellad, MD, MPH

Erschienen in: Journal of General Internal Medicine | Ausgabe 10/2011

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Abstract

Objective

To conduct a meta-analysis of the association between depression and medication adherence among patients with chronic diseases. Poor medication adherence may result in worse outcomes and higher costs than if patients fully adhere to their medication regimens.

Data Sources

We searched the PubMed and PsycINFO databases, conducted forward searches for articles that cited major review articles, and examined the reference lists of relevant articles.

Study Eligibility Criteria, Participants, and Interventions

We included studies on adults in the United States that reported bivariate relationships between depression and medication adherence. We excluded studies on special populations (e.g., substance abusers) that were not representative of the general adult population with chronic diseases, studies on certain diseases (e.g., HIV) that required special adherence protocols, and studies on interventions for medication adherence.

Study Appraisal and Synthesis Methods

Data abstracted included the study population, the protocol, measures of depression and adherence, and the quantitative association between depression and medication adherence. Synthesis of the data followed established statistical procedures for meta-analysis.

Results

The estimated odds of a depressed patient being non-adherent are 1.76 times the odds of a non-depressed patient, across 31 studies and 18,245 participants. The association was similar across disease types but was not as strong among studies that used pharmacy records compared to self-report and electronic cap measures.

Limitations

The meta-analysis results are correlations limiting causal inferences, and there is some heterogeneity among the studies in participant characteristics, diseases studied, and methods used.

Conclusions

This analysis provides evidence that depression is associated with poor adherence to medication across a range of chronic diseases, and we find a new potential effect of adherence measurement type on this relationship. Although this study cannot assess causality, it supports the importance that must be placed on depression in studies that assess adherence and attempt to improve it.
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Metadaten
Titel
Depression and Medication Adherence in the Treatment of Chronic Diseases in the United States: A Meta-Analysis
verfasst von
Jerry L. Grenard, PhD
Brett A. Munjas, MS
John L. Adams, PhD
Marika Suttorp, MS
Margaret Maglione, MPP
Elizabeth A. McGlynn, PhD
Walid F. Gellad, MD, MPH
Publikationsdatum
01.10.2011
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 10/2011
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-011-1704-y

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