Publication

Non-adherence to cardiovascular drugs in older patients with depression: A population-based cohort study

Holvast, F., Wouters, H., Hek, K., Schellevis, F., Voshaar, R. O., van Dijk, L., Burger, H. & Verhaak, P., 1-Jan-2019, In : International Journal of Cardiology. 274, p. 366-371 6 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Holvast, F., Wouters, H., Hek, K., Schellevis, F., Voshaar, R. O., van Dijk, L., ... Verhaak, P. (2019). Non-adherence to cardiovascular drugs in older patients with depression: A population-based cohort study. International Journal of Cardiology, 274, 366-371. https://doi.org/10.1016/j.ijcard.2018.08.100

Author

Holvast, Floor ; Wouters, Hans ; Hek, Karin ; Schellevis, Francois ; Voshaar, Richard Oude ; van Dijk, Liset ; Burger, Huibert ; Verhaak, Peter. / Non-adherence to cardiovascular drugs in older patients with depression : A population-based cohort study. In: International Journal of Cardiology. 2019 ; Vol. 274. pp. 366-371.

Harvard

Holvast, F, Wouters, H, Hek, K, Schellevis, F, Voshaar, RO, van Dijk, L, Burger, H & Verhaak, P 2019, 'Non-adherence to cardiovascular drugs in older patients with depression: A population-based cohort study', International Journal of Cardiology, vol. 274, pp. 366-371. https://doi.org/10.1016/j.ijcard.2018.08.100

Standard

Non-adherence to cardiovascular drugs in older patients with depression : A population-based cohort study. / Holvast, Floor; Wouters, Hans; Hek, Karin; Schellevis, Francois; Voshaar, Richard Oude; van Dijk, Liset; Burger, Huibert; Verhaak, Peter.

In: International Journal of Cardiology, Vol. 274, 01.01.2019, p. 366-371.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Holvast F, Wouters H, Hek K, Schellevis F, Voshaar RO, van Dijk L et al. Non-adherence to cardiovascular drugs in older patients with depression: A population-based cohort study. International Journal of Cardiology. 2019 Jan 1;274:366-371. https://doi.org/10.1016/j.ijcard.2018.08.100


BibTeX

@article{2c97200d0a234cd08efd62b0651fbb0c,
title = "Non-adherence to cardiovascular drugs in older patients with depression: A population-based cohort study",
abstract = "Background: Depression is common among patients with cardiovascular disease and has been associated with both drug non-adherence and increased mortality. Non-adherence can occur because of non-initiation, suboptimal implementation, or non-persistence. We aimed to determine if depression increased the risk of any of these components of non-adherence among older patients prescribed cardiovascular drugs in primary care.Methods: A longitudinal analysis of routine primary care data from the Nivel Primary Care Database was performed using data for 2011-2013. A total of 1512 patients aged >= 60 years diagnosed with depression in 2012 were compared with age-and sex-matched groups with either other psychological diagnoses (N = 1457) or mentally healthy controls (N = 1508), resulting in the inclusion of 4477 patients. Non-adherence was classified as non-initiation, suboptimal implementation, or non-persistence. Regression analyses were performed to determine the association between mental health status and non-initiation, suboptimal implementation, and non-persistence.Results: Mixed-effects logistic regression analyses showed increased odds for suboptimal implementation of beta-blockers among depressed patients (2.18; 95{\%} CI 1.29-3.69). For non-persistence, a clustered Cox regression analysis demonstrated that, compared with controls, there was an increased hazard ratio for depressed patients to discontinue beta-blockers (2.31; 95{\%} CI 1.58-3.37) and calcium antagonists (1.74; 95{\%} CI 1.23-2.46).Conclusions: It is likely that older patients in primary care diagnosed with depression are at increased risk of non-persistence with cardiovascular drug therapy. Because non-adherence is associated with increased cardiovascular mortality, it is important that physicians ensure that older depressed patients persevere with therapy. (c) 2018 Published by Elsevier B.V.",
keywords = "Depression, Aged, Non-adherence, Cardiovascular drugs, Primary health care, ANTIHYPERTENSIVE MEDICATION ADHERENCE, PRIMARY-CARE, SYMPTOMS, ASSOCIATION, PERSISTENCE, DISEASE, ADULTS, LIFE, MULTIMORBIDITY",
author = "Floor Holvast and Hans Wouters and Karin Hek and Francois Schellevis and Voshaar, {Richard Oude} and {van Dijk}, Liset and Huibert Burger and Peter Verhaak",
year = "2019",
month = "1",
day = "1",
doi = "10.1016/j.ijcard.2018.08.100",
language = "English",
volume = "274",
pages = "366--371",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "ELSEVIER IRELAND LTD",

}

RIS

TY - JOUR

T1 - Non-adherence to cardiovascular drugs in older patients with depression

T2 - A population-based cohort study

AU - Holvast, Floor

AU - Wouters, Hans

AU - Hek, Karin

AU - Schellevis, Francois

AU - Voshaar, Richard Oude

AU - van Dijk, Liset

AU - Burger, Huibert

AU - Verhaak, Peter

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: Depression is common among patients with cardiovascular disease and has been associated with both drug non-adherence and increased mortality. Non-adherence can occur because of non-initiation, suboptimal implementation, or non-persistence. We aimed to determine if depression increased the risk of any of these components of non-adherence among older patients prescribed cardiovascular drugs in primary care.Methods: A longitudinal analysis of routine primary care data from the Nivel Primary Care Database was performed using data for 2011-2013. A total of 1512 patients aged >= 60 years diagnosed with depression in 2012 were compared with age-and sex-matched groups with either other psychological diagnoses (N = 1457) or mentally healthy controls (N = 1508), resulting in the inclusion of 4477 patients. Non-adherence was classified as non-initiation, suboptimal implementation, or non-persistence. Regression analyses were performed to determine the association between mental health status and non-initiation, suboptimal implementation, and non-persistence.Results: Mixed-effects logistic regression analyses showed increased odds for suboptimal implementation of beta-blockers among depressed patients (2.18; 95% CI 1.29-3.69). For non-persistence, a clustered Cox regression analysis demonstrated that, compared with controls, there was an increased hazard ratio for depressed patients to discontinue beta-blockers (2.31; 95% CI 1.58-3.37) and calcium antagonists (1.74; 95% CI 1.23-2.46).Conclusions: It is likely that older patients in primary care diagnosed with depression are at increased risk of non-persistence with cardiovascular drug therapy. Because non-adherence is associated with increased cardiovascular mortality, it is important that physicians ensure that older depressed patients persevere with therapy. (c) 2018 Published by Elsevier B.V.

AB - Background: Depression is common among patients with cardiovascular disease and has been associated with both drug non-adherence and increased mortality. Non-adherence can occur because of non-initiation, suboptimal implementation, or non-persistence. We aimed to determine if depression increased the risk of any of these components of non-adherence among older patients prescribed cardiovascular drugs in primary care.Methods: A longitudinal analysis of routine primary care data from the Nivel Primary Care Database was performed using data for 2011-2013. A total of 1512 patients aged >= 60 years diagnosed with depression in 2012 were compared with age-and sex-matched groups with either other psychological diagnoses (N = 1457) or mentally healthy controls (N = 1508), resulting in the inclusion of 4477 patients. Non-adherence was classified as non-initiation, suboptimal implementation, or non-persistence. Regression analyses were performed to determine the association between mental health status and non-initiation, suboptimal implementation, and non-persistence.Results: Mixed-effects logistic regression analyses showed increased odds for suboptimal implementation of beta-blockers among depressed patients (2.18; 95% CI 1.29-3.69). For non-persistence, a clustered Cox regression analysis demonstrated that, compared with controls, there was an increased hazard ratio for depressed patients to discontinue beta-blockers (2.31; 95% CI 1.58-3.37) and calcium antagonists (1.74; 95% CI 1.23-2.46).Conclusions: It is likely that older patients in primary care diagnosed with depression are at increased risk of non-persistence with cardiovascular drug therapy. Because non-adherence is associated with increased cardiovascular mortality, it is important that physicians ensure that older depressed patients persevere with therapy. (c) 2018 Published by Elsevier B.V.

KW - Depression

KW - Aged

KW - Non-adherence

KW - Cardiovascular drugs

KW - Primary health care

KW - ANTIHYPERTENSIVE MEDICATION ADHERENCE

KW - PRIMARY-CARE

KW - SYMPTOMS

KW - ASSOCIATION

KW - PERSISTENCE

KW - DISEASE

KW - ADULTS

KW - LIFE

KW - MULTIMORBIDITY

U2 - 10.1016/j.ijcard.2018.08.100

DO - 10.1016/j.ijcard.2018.08.100

M3 - Article

VL - 274

SP - 366

EP - 371

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -

ID: 71967383