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Extent and reasons for nonadherence to antihypertensive, cholesterol, and diabetes medications: the association with depressive symptom burden in a sample of American veterans

机译：不坚持服用降压药，胆固醇和糖尿病药物的程度和原因：美国退伍军人样本中与抑郁症状负担相关

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Objective: Persons with depressive symptoms generally have higher rates of medication nonadherence than persons without depressive symptoms. However, little is known about whether this association differs by comorbid medical condition or whether reasons for nonadherence differ by depressive symptoms or comorbid medical condition. Methods: Self-reported extent of nonadherence, reasons for nonadherence, and depressive symptoms among 1,026 veterans prescribed medications for hypertension, dyslipidemia, and/or type 2 diabetes were assessed. Results: In multivariable logistic regression adjusted for clinical and demographic factors, the odds of nonadherence were higher among participants with high depressive symptom burden for dyslipidemia (n=848; odds ratio [OR]: 1.42, P=0.03) but not hypertension (n=916; OR: 1.24, P=0.15), or type 2 diabetes (n=447; OR: 1.15, P=0.51). Among participants reporting nonadherence to antihypertensive and antilipemic medications, those with greater depressive symptom burden had greater odds of endorsing medication nonadherence reasons related to negative expectations and excessive economic burden. Neither extent of nonadherence nor reasons for nonadherence differed by depressive symptom burden among patients with diabetes. Conclusion: These findings suggest that clinicians may consider tailoring interventions to improve adherence to antihypertensive and antilipemic medications to specific medication concerns of participants with depressive symptoms.
机译：目的：具有抑郁症状的人通常比没有抑郁症状的人有更高的药物不依从率。但是，关于这种关联是否因合并症而有所不同，或者因抑郁症状或合并症而导致不依从的原因也知之甚少。方法：对1,026名退伍军人处方的高血压，血脂异常和/或2型糖尿病药物的自我报告的不依从程度，不依依原因和抑郁症状进行评估。结果：在针对临床和人口统计学因素进行校正的多变量logistic回归中，血脂异常的高抑郁症状负担高的参与者（n = 848;比值比[OR]：1.42，P = 0.03）中非依从性的可能性更高，而高血压（n = 916; OR：1.24，P = 0.15）或2型糖尿病（n = 447; OR：1.15，P = 0.51）。在报告不坚持服用降压药和降血脂药物的参与者中，抑郁症状负担较大的参与者赞同与否定预期和过度经济负担相关的不坚持药物治疗的可能性。糖尿病患者的抑郁症状负担对不依从的程度和不依从的原因均没有区别。结论：这些发现表明，临床医生可以考虑量身定制干预措施，以提高对降压和抗血脂药物的依从性，以解决抑郁症患者的特定用药问题。

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