Depressive Symptoms and Adherence to Asthma Therapy After Hospital Discharge
Amena Smith, Jerry A. Krishnan, Andrew Bilderback, Kristin A. Riekert, Cynthia S. Rand, and Susan J. Bartlett. Chest 130: 1034-1038
Depressed Asthmatics Often Stop Treatment
Megan Rauscher Reuters. Scientific American October 20, 2006
[Note: This post is an addendum to and expansion of an earlier blog entry, Depression & Decreased Adherence To Asthma Therapy. Information about CME associated with this study is available in that earlier post.]
This study is a straightforward, valuable assessment of “the effect of depressive symptoms on adherence to therapy after discharge in patients hospitalized for asthma exacerbations.
Study Parameters
A prospective cohort of 59 adult patients hospitalized for an exacerbation of asthma were assessed for depression with the Center for Epidemiological Studies-Depression scale and then electronically monitored for adherence to their prescribed regimens of inhaled corticosteroid and oral corticosteroid for 2 weeks following discharge.
Results
Adherence was lower in the 41% of patients who met criteria for depression even after adjustments for potential confounders (age, gender, and education).
Commentary
Dr. Barlett’s comment, as quoted in Scientific American captures the implications of the study:
The study’s authors were careful to note that it is unproven whether or not treating the depression in such patients would improve medication adherence, but confirming the long held clinical suspicion that affective symptoms, an especially common comorbidity with asthma, has a negative impact on compliance is a significant step forward.