1. Association of depression and anxiety with adherence in primary care patients with heart failure—cross-sectional results of the observational RECODE-HF cohort study
- Author
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Martin Scherer, Anja Rakebrandt, Jens-Martin Träder, Malte Harder, Sigrid Boczor, Stefan Störk, Eva Blozik, Christoph Herrmann-Lingen, Gabriella Marx, and Marion Eisele
- Subjects
Male ,medicine.medical_specialty ,Anxiety ,030204 cardiovascular system & hematology ,Medication Adherence ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Quality of life ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Depression (differential diagnoses) ,Aged ,Aged, 80 and over ,Heart Failure ,2. Zero hunger ,Primary Health Care ,Depression ,business.industry ,Health services research ,Middle Aged ,medicine.disease ,3. Good health ,Cross-Sectional Studies ,Heart failure ,Quality of Life ,Female ,Observational study ,medicine.symptom ,Family Practice ,business ,Body mass index ,Cohort study - Abstract
Background Psychological distress has a negative impact on the prognosis and quality of life for patients with heart failure. We investigated the association between psychological distress and the patients’ adherence to medical treatment (medication adherence) and self-care advice (lifestyle adherence) in heart failure. We further examined whether there are different factors associated with low medication compared to low lifestyle adherence. Method This secondary analysis of the RECODE-HF cohort study analyzed baseline data of 3099 primary care heart failure patients aged 74 ± 10 years, 44.5 % female. Using multivariable regression, factors relating to medication and lifestyle adherence were investigated in order to estimate the extent to which these factors confound the association between psychological distress and adherence. Results Psychological distress was significantly associated with poorer medication adherence but not with lifestyle adherence after controlling for confounders. We identified different factors associated with medication compared to lifestyle adherence. A higher body mass index, a less developed social network, living alone, fewer chronic co-morbidities and unawareness of the heart failure diagnosis were only related to lower lifestyle adherence. Higher education was associated with poorer medication adherence. Male sex, younger age, lower self-efficacy and less familiar relation with the general practitioner were common factors associated with both lower medication and lifestyle adherence. Conclusion Promising factors for increasing medication adherence (reduction of psychological distress) and lifestyle adherence (explaining the patient his/her heart failure diagnosis more than once and increase in the patients’ self-efficacy), which were found in this cross-sectional study, must be further investigated in longitudinal studies.
- Published
- 2020