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How does depression influence diabetes medication adherence in older patients?
Amy M Kilbourne1, Charles F Reynolds, Chester B Good
1VA Pittsburgh Center for Health Equity Research and Promotion, General Internal Medicine (151-C), University Drive C, Pittsburgh, PA 15240, USA. Amy.Kilbourne@med.va.gov
Summary
Depression is linked to poor diabetes medication adherence in older adults. This study found that depressed patients were less likely to take their medications as prescribed, impacting blood sugar control.
Area of Science:
- Gerontology
- Endocrinology
- Psychiatry
Background:
- Type 2 diabetes management requires consistent medication adherence.
- Depression is a common comorbidity in older adults with chronic conditions.
- Accurate assessment of medication adherence is crucial for effective diabetes care.
Purpose of the Study:
- To examine the association between depression and medication adherence in older adults with Type 2 diabetes.
- To compare adherence data from multiple sources: electronic monitoring, patient/provider reports, and pharmacy refill data.
Main Methods:
- 203 older adults with Type 2 diabetes completed depression surveys and used electronic monitoring caps (EMCs) for oral hypoglycemic medications.
- Patient and provider adherence surveys were administered at baseline and 30 days.
- Pharmacy refill data were collected for up to 1 year to assess medication coverage.
Main Results:
- 10% of patients reported depressive symptoms.
- Depressed patients showed lower self-reported adherence and less adequate medication coverage via pharmacy data.
- After adjusting for covariates, depression remained associated with inadequate adherence based on patient reports and pharmacy data.
Conclusions:
- Depression is an independent predictor of inadequate medication adherence in older adults with Type 2 diabetes.
- Patient self-report and pharmacy refill data are valuable measures for identifying adherence issues in this population.