Medication adherence, depression and PCI: a review
Depression is known to be associated with a higher risk of primary and secondary cardiovascular events occurring. For example, depression is linked to a 4-fold increased risk of cardiovascular morbidity and mortality compared to those without depression. One of the reasons behind this is thought to be the link between depression and medication adherence. Medication adherence is affected by many known factors, including financial strain or social barriers such as the absence of transportation to pharmacies. This study explored the links between depression and adherence to guideline-directed medical therapies such as anti-platelet agents or β-blockers, given to patients after percutaneous coronary intervention. This study evaluated 124,443 patients, and found that overall, adherence to medication was significantly lower in depressed patients than non-depressed patients. However, this is difficult to screen for, as patients may resist in reporting depressive symptoms, and clinicians may have poor screening tools.
This review by Lapa ME et al. aimed to understand the adherence to cardiac medication, comparing patients with depression and without depression who have coronary heart disease.
Overall, patients with depression were less likely to take adequate amounts of medication, which is essential to guideline-directed therapies after percutaneous coronary intervention, than patients without depression. Therefore, recognising depression as a factor in medication adherence may aid in decreasing secondary cardiovascular disease occurrence. The American Heart Association has also recommended screening for depression in all patients with coronary disease.