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Relevance of depression for anticoagulation management in a routine medical care setting: results from the ThrombEVAL

M Michal1, J H Prochaska, A Ullmann

  • 1Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.

Journal of Thrombosis and Haemostasis : JTH
|October 9, 2014
PubMed

Insights

Depression significantly impacts anticoagulation treatment, leading to lower compliance and satisfaction. Addressing depressive symptoms is crucial for managing patients on blood thinners.

Area of Science:

  • Internal Medicine
  • Psychiatry
  • Pharmacology

Background:

  • Depressive symptoms negatively affect quality of life and mortality.
  • Poor treatment adherence, often linked to depression, increases adverse medical event risks.
  • Adherence to oral anticoagulation is vital for patient outcomes.

Purpose of the Study:

  • To investigate the clinical relevance of current depressive symptoms in patients undergoing anticoagulation therapy.
  • To assess the impact of depression on anticoagulation treatment adherence, health literacy, side-effects, and satisfaction.

Main Methods:

  • Cross-sectional study of 1790 outpatients on oral anticoagulation.
  • Assessed clinically significant depressive symptoms using Patient Health Questionnaire-2 (PHQ-2 ≥ 2).
  • Examined associations with time in therapeutic range (TTR), self-rated compliance, health literacy, side-effects, and treatment satisfaction.

Main Results:

  • 40% of patients exhibited clinically significant depressive symptoms.
  • Depressed patients reported lower medication adherence, fewer control visits, more side-effects, and reduced treatment satisfaction.
  • Depressed individuals had a lower TTR, though this association lost significance after multivariable adjustment.

Conclusions:

  • Clinically significant depression is highly prevalent among anticoagulation patients.
  • Depression impairs treatment adherence, satisfaction, and potentially anticoagulation control.
  • Depressive symptoms require clinical attention in managing anticoagulation therapy.
Abstract

Keywords:
ambulatory careanticoagulantsdepressionmedication adherencepatient satisfactionphenprocoumon

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