Course of Depressive Symptoms and Medication Adherence After Acute Coronary Syndromes. An Electronic Medication Monitoring Study

Nina Rieckmann, William Gerin, Ian M. Kronish, Matthew M. Burg, William F. Chaplin, Grace Kong, François Lespérance, Karina W. Davidson

Research output: Contribution to journalArticlepeer-review

129 Scopus citations

Abstract

Objectives: We tested whether improvements in depressive symptoms precede improved adherence to aspirin in patients with acute coronary syndromes (ACS). Background: Depression is associated with medication nonadherence in patients with ACS, but it is unclear whether changes in depression impact on adherence. Methods: Electronic medication monitoring was used to measure adherence to aspirin during a 3-month period in a consecutive cohort of 172 patients (25 to 85 years) recruited within 1 week of hospitalization for ACS. Depressive symptom severity was assessed using the Beck Depression Inventory (BDI) during hospitalization and at 1 and 3 months after hospitalization. Adherence was defined as the percentage of days aspirin was taken as prescribed. Results: Depression severity in hospital was associated with nonadherence in a gradient fashion: 15% of non-depressed patients (BDI score 0 to 4), 29% of mildly depressed patients (BDI score 10 to 16), and 37% of patients with moderately-to-severely depressive symptoms (BDI score >16) took aspirin less than 80% of the time (p = 0.03). A cross-lagged path analytic model revealed that improvements in depressive symptoms in the first month after the ACS were associated with improvements in adherence rates in the subsequent 2 months (standardized direct effect -0.32, p = 0.016). Conclusions: Diagnosis and treatment of depressive symptoms may improve medication adherence in patients after ACS.

Original languageEnglish (US)
Pages (from-to)2218-2222
Number of pages5
JournalJournal of the American College of Cardiology
Volume48
Issue number11
DOIs
StatePublished - Dec 5 2006

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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