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Depression and Medication Adherence in the Treatment of Chronic Diseases in the United States: A Meta-Analysis
Open accessAbstract
Objective To conduct a meta-analysis of the association between depression and medication adherence among patients with chronic diseases. Poor medication adherence may result in worse outcomes and higher costs than if patients fully adhere to their medication regimens.Data sources We searched the PubMed and PsycINFO databases, conducted forward searches for articles that cited major review articles, and examined the reference lists of relevant articles.Study eligibility criteria, participants, and interventions We included studies on adults in the United States that reported bivariate relationships between depression and medication adherence. We excluded studies on special populations (e.g., substance abusers) that were not representative of the general adult population with chronic diseases, studies on certain diseases (e.g., HIV) that required special adherence protocols, and studies on interventions for medication adherence.Study appraisal and synthesis methods Data abstracted included the study population, the protocol, measures of depression and adherence, and the quantitative association between depression and medication adherence. Synthesis of the data followed established statistical procedures for meta-analysis.Results The estimated odds of a depressed patient being non-adherent are 1.76 times the odds of a non-depressed patient, across 31 studies and 18,245 participants. The association was similar across disease types but was not as strong among studies that used pharmacy records compared to self-report and electronic cap measures.Limitations The meta-analysis results are correlations limiting causal inferences, and there is some heterogeneity among the studies in participant characteristics, diseases studied, and methods used.Conclusions This analysis provides evidence that depression is associated with poor adherence to medication across a range of chronic diseases, and we find a new potential effect of adherence measurement type on this relationship. Although this study cannot assess causality, it supports the importance that must be placed on depression in studies that assess adherence and attempt to improve it.
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“Psychological distress in patients with CF has been associated with a number of negative consequences and health outcomes, including worse adherence, 7 14 worse pulmonary function, 10 15 increased hospitalisations and healthcare costs, 16 and decreased health-related quality of life.8 9”
From Prevalence of depression and anxiety in patients with cystic fibrosis and parent caregivers: results of The International Depression Epidemiological Study across nine countries (2014) · cites this paper as [14]
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“MDD is also associated with reduced adherence to treatment for chronic diseases, which may further exacerbate disease outcomes140.”
From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [140]
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Metadata
- Authors
- Grenard, J. L., Munjas, B. A., Adams, J. L., Suttorp, M., Maglione, M., McGlynn, E. A., & Gellad, W. F.
- Affiliations
- Claremont Graduate University (US)
- RAND Corporation (US)
- Kaiser Permanente (US)
- Corresponding author
- Grenard, Jerry L.
- Venue
- Journal of General Internal Medicine
- Published
- 2011-05-01
- Volume
- 26
- Issue
- 10
- Pages
- 1175-1182
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC3181287
- OpenAlex
- W1981198734
- Cited by
- 635
- References
- 92
- Citations by year
- 2026: 40 · 2025: 59 · 2024: 53 · 2023: 57 · 2022: 58 · 2021: 52 · 2020: 63 · 2019: 33 · 2018: 42 · 2017: 44 · 2016: 32 · 2015: 35 · 2014: 31 · 2013: 23 · 2012: 11
- FWCI
- 3.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Scholarship @ Claremont (The Claremont Colleges) (submittedVersion)
- Funders
- U.S. Department of Veterans Affairs (CDA 09-207)
- Agency for Healthcare Research and Quality (T32HS000046, T32 HS00046-14, T32-HS00046)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- depression, medication adherence, chronic disease, non-compliance, adherence measurement, pharmacy records, electronic medication monitoring, self-report
- MeSH terms
- Chronic Disease, Depression, Humans, United States, Randomized Controlled Trials as Topic, Treatment Outcome, Medication Adherence
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