Depression decreases medication adherence maintenance of COPD ;
A recent study in Annals of the American Thoracic Society found that in a nationally representative sample of Medicare beneficiaries who were newly diagnosed with COPD, adherence to maintenance medications decreased with new episodes of depression.
“With a prevalence of 17 to 44 percent, depression remains one but less recognized and under-treated, more common among patients with COPD co-morbidities,” said researcher Linda Simoni-Wastila, BSPharm, MSPH, PhD, professor in the Department of Pharmaceutical Health Research at the University of Maryland School of Pharmacy in Baltimore. “While depression has been associated with reduced use of maintenance medication in other chronic conditions , this is the first study to document the role of causality of comorbid depression in reduced adherence COPD medication in older adults with COPD. ”
The study, “Adherence to medication maintenance in older adults with chronic obstructive pulmonary disease: The Role of Depression,” the researchers obtained data from administrative claims of Medicare Centers for Medicare and Medicaid Chronic Condition store data and assessed five percent random sample of Medicare beneficiaries (average age 68 years) from 2006? 2012. This includes beneficiaries with two years of continuous Medicare Parts A, B and D coverage, and at least two full prescription of inhaled corticosteroids, beta-agonists, long-acting and long-acting anticholinergics.
Adherence is based on the number of prescriptions. The presence of depression was defined as at least one diagnostic code in at least one claim inpatient or outpatient at least two claims during the study period.
Of the 31.033 beneficiaries who meet the inclusion criteria, 20 percent were diagnosed with depression after diagnosis of COPD. Average monthly adherence to maintenance medication of COPD was low, reaching a peak of 57 percent in the month following the first filling, and decreased 25 percent within 6 months.
“We were able to identify depression as a risk factor for not using drugs COPD, finding that older adults with respiratory disease have a tendency to not fully use the medications prescribed by their disease,” said Dr . Simoni-Wastila. The researchers also noted that “physicians who treat older adults with newly diagnosed COPD should be aware of the development of depression, especially during the first six months.”
“It is our long-term hope that this study will help policy makers, professionals and patients and their caregivers think about their health more holistically, and consider how the presence of a treated or medical condition untreated can influence the progression and management of other medical conditions. ”
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