Depression, anxiety, perceived stress, and their changes predicted medical adherence over 9 months among patients
Yunge Fan1, Biing-Jiun Shen1, Hung Yong Tay2
1Psychology Program, Nanyang Technological University, Singapore City, Singapore.
Insights
Psychological distress, including depression and anxiety, significantly impacts treatment adherence in coronary heart disease (CHD) patients. Monitoring distress levels over time is crucial for improving adherence and patient outcomes.
Area of Science:
- Cardiology
- Psychiatry
- Behavioral Medicine
Background:
- Coronary heart disease (CHD) patients often struggle with treatment adherence despite effective medical interventions.
- Psychological distress is known to negatively affect adherence, but the impact of changes in distress remains understudied.
Purpose of the Study:
- To investigate if depression, anxiety, and perceived stress, and their changes over 9 months, predict declining medical adherence in CHD patients.
Main Methods:
- A three-wave longitudinal study involving 255 CHD patients (mean age 63).
- Assessed psychological distress, medication adherence, and specific treatment adherence at baseline, 3, and 9 months.
- Utilized hierarchical regression analyses, controlling for covariates.
Main Results:
- Baseline depression and its changes predicted reduced medication and specific adherence.
- Anxiety changes showed a similar trend.
- Perceived stress predicted specific adherence decline, but not medication adherence.
Conclusions:
- Tracking psychological distress over time is essential for CHD patients.
- Interventions targeting distress can improve medical adherence and patient prognosis.
Objectives:
Although effective medical treatments have proved to successfully improve prognoses and outcomes of patients with coronary heart disease (CHD), low adherence to treatments is still common among patients. Deleterious impact of psychological distress on medical adherence has been recognized; however, few studies examined the influence of change in psychological distress on attenuation in adherence. This study investigated whether three common manifestations of distress (depression, anxiety, and perceived stress) and their changes predicted decline in medical adherence among CHD patient over 9 months.
Design:
A three-wave longitudinal study.
Methods:
Participants were 255 CHD patients with a mean age of 63 years. Psychological distress, medication adherence, and specific treatment adherence were assessed at baseline, 3 months, and 9 months. Hierarchical regression analyses were conducted to examine the influences of psychological distress on medical adherence over 9 months. All models were adjusted for baseline medication or specific adherence, demographic, and medical covariates.
Results:
Baseline depression and its changes over time significantly predicted greater decline in both medication adherence (βs = .15-.20, ps < .05) and specific adherence (βs = -.21 to -.15, ps < .05). Anxiety showed a similar trend. For perceived stress, baseline and its change significantly predicted specific adherence over 9 months (βs = -.30 to -.23, ps < .01), but did not predict medication adherence at 3 and 9 months.
Conclusions:
Findings underline the necessity of tracking various forms of psychological distress over time for CHD patients to promote medical adherence and further improve the disease prognosis.
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