Depression important contributor to low medication adherence: hemo + TX

[okarol]

Kidney International advance online publication 25 February 2009; doi: 10.1038/ki.2009.51
Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients

Daniel Cukor1, Deborah S Rosenthal1,2, Rahul M Jindal3, Clinton D Brown4 and Paul L Kimmel5

   1. 1Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, New York, USA
   2. 2Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
   3. 3Department of Surgery and Organ Transplant Service, Walter Reed Army Medical Center and Uniformed Services University of the Health Sciences, Washington, DC, USA
   4. 4Department of Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA
   5. 5Department of Medicine, George Washington University, Washington, DC, USA

Correspondence: Daniel Cukor, Department of Psychiatry and Behavioral Science, SUNY Downstate Medical Center, 450 Clarkson Avenue, Box 1203, Brooklyn, New York 11203-2098, USA. E-mail: Daniel.Cukor@downstate.edu

Received 17 October 2008; Revised 3 January 2009; Accepted 7 January 2009; Published online 25 February 2009.
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Abstract

End-stage renal disease (ESRD) is a growing public health concern and non-adherence to treatment has been associated with poorer health outcomes in this population. Depression, likely to be the most common psychopathology in such patients, is associated with increased morbidity and mortality. We compared psychological measures and self-reported medication adherence of 94 kidney transplant recipients to those of 65 patients receiving hemodialysis in a major medical center in Brooklyn, New York. Compared to the transplant group, the hemodialysis cohort was significantly more depressed as determined by the Beck Depression Inventory score. They also had a significantly lower adherence to medication as reported on the Medication Therapy Adherence Scale. Using hierarchical multiple regression analysis, the variance in depression was the only statistically significant predictor of medication adherence beyond gender and mode of treatment, accounting for an additional 12% of the variance. Our study strongly suggests that a depressive affect is an important contributor to low medication adherence in patients with ESRD on hemodialysis or kidney transplant recipients.

http://www.nature.com/ki/journal/vaop/ncurrent/abs/ki200951a.html

[Sluff]

I think I can agree with the headline of this article.

[RightSide]

I had a bout of Major Depression once, long before my kidneys started failing.  One of the symptoms was that I started becoming forgetful.  And sometimes I would forget if I had already taken my prescribed medication or not.  To avoid a double dose, I would not take it, and that's how I often didn't take my daily medication.