Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study

Marion Eisele; Malte Harder; Anja Rakebrandt; Sigrid Boczor; Gabriella Marx; Eva Blozik; Jens Martin Träder; Stefan Störk; Christoph Herrmann-Lingen; Martin Scherer

doi:10.1093/fampra/cmaa042

Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study

Marion Eisele
, Malte Harder
, Anja Rakebrandt
, Sigrid Boczor
, Gabriella Marx
, Eva Blozik
, Jens Martin Träder
, Stefan Störk
, Christoph Herrmann-Lingen
, Martin Scherer

University Hospital Hamburg-Eppendorf
University of Würzburg
German Centre for Cardiovascular Research (DZHK)

21 Citations (Scopus)

Abstract

BACKGROUND: Psychological distress has a negative impact on the prognosis and quality of life for patients with heart failure. We investigated the association between psychological distress and the patients' adherence to medical treatment (medication adherence) and self-care advice (lifestyle adherence) in heart failure. We further examined whether there are different factors associated with low medication compared to low lifestyle adherence. METHOD: This secondary analysis of the RECODE-HF cohort study analyzed baseline data of 3099 primary care heart failure patients aged 74 ± 10 years, 44.5 % female. Using multivariable regression, factors relating to medication and lifestyle adherence were investigated in order to estimate the extent to which these factors confound the association between psychological distress and adherence. RESULTS: Psychological distress was significantly associated with poorer medication adherence but not with lifestyle adherence after controlling for confounders. We identified different factors associated with medication compared to lifestyle adherence. A higher body mass index, a less developed social network, living alone, fewer chronic co-morbidities and unawareness of the heart failure diagnosis were only related to lower lifestyle adherence. Higher education was associated with poorer medication adherence. Male sex, younger age, lower self-efficacy and less familiar relation with the general practitioner were common factors associated with both lower medication and lifestyle adherence. CONCLUSION: Promising factors for increasing medication adherence (reduction of psychological distress) and lifestyle adherence (explaining the patient his/her heart failure diagnosis more than once and increase in the patients' self-efficacy), which were found in this cross-sectional study, must be further investigated in longitudinal studies.

Original language	English
Journal	Family Practice
Volume	37
Issue number	5
Pages (from-to)	695-702
Number of pages	8
ISSN	0263-2136
DOIs	https://doi.org/10.1093/fampra/cmaa042
Publication status	Published - 19.10.2020

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Research Area: Center for Population Medicine and Public Health (ZBV)

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10.1093/fampra/cmaa042

Cite this

Eisele, M., Harder, M., Rakebrandt, A., Boczor, S., Marx, G., Blozik, E., Träder, J. M., Störk, S., Herrmann-Lingen, C., & Scherer, M. (2020). Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study. Family Practice, 37(5), 695-702. https://doi.org/10.1093/fampra/cmaa042

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title = "Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study",

abstract = "BACKGROUND: Psychological distress has a negative impact on the prognosis and quality of life for patients with heart failure. We investigated the association between psychological distress and the patients' adherence to medical treatment (medication adherence) and self-care advice (lifestyle adherence) in heart failure. We further examined whether there are different factors associated with low medication compared to low lifestyle adherence. METHOD: This secondary analysis of the RECODE-HF cohort study analyzed baseline data of 3099 primary care heart failure patients aged 74 ± 10 years, 44.5 \% female. Using multivariable regression, factors relating to medication and lifestyle adherence were investigated in order to estimate the extent to which these factors confound the association between psychological distress and adherence. RESULTS: Psychological distress was significantly associated with poorer medication adherence but not with lifestyle adherence after controlling for confounders. We identified different factors associated with medication compared to lifestyle adherence. A higher body mass index, a less developed social network, living alone, fewer chronic co-morbidities and unawareness of the heart failure diagnosis were only related to lower lifestyle adherence. Higher education was associated with poorer medication adherence. Male sex, younger age, lower self-efficacy and less familiar relation with the general practitioner were common factors associated with both lower medication and lifestyle adherence. CONCLUSION: Promising factors for increasing medication adherence (reduction of psychological distress) and lifestyle adherence (explaining the patient his/her heart failure diagnosis more than once and increase in the patients' self-efficacy), which were found in this cross-sectional study, must be further investigated in longitudinal studies.",

author = "Marion Eisele and Malte Harder and Anja Rakebrandt and Sigrid Boczor and Gabriella Marx and Eva Blozik and Tr{\"a}der, \{Jens Martin\} and Stefan St{\"o}rk and Christoph Herrmann-Lingen and Martin Scherer",

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month = oct,

day = "19",

doi = "10.1093/fampra/cmaa042",

language = "English",

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Eisele, M, Harder, M, Rakebrandt, A, Boczor, S, Marx, G, Blozik, E, Träder, JM, Störk, S, Herrmann-Lingen, C & Scherer, M 2020, 'Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study', Family Practice, vol. 37, no. 5, pp. 695-702. https://doi.org/10.1093/fampra/cmaa042

TY - JOUR

T1 - Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study

AU - Eisele, Marion

AU - Harder, Malte

AU - Rakebrandt, Anja

AU - Boczor, Sigrid

AU - Marx, Gabriella

AU - Blozik, Eva

AU - Träder, Jens Martin

AU - Störk, Stefan

AU - Herrmann-Lingen, Christoph

AU - Scherer, Martin

PY - 2020/10/19

Y1 - 2020/10/19

N2 - BACKGROUND: Psychological distress has a negative impact on the prognosis and quality of life for patients with heart failure. We investigated the association between psychological distress and the patients' adherence to medical treatment (medication adherence) and self-care advice (lifestyle adherence) in heart failure. We further examined whether there are different factors associated with low medication compared to low lifestyle adherence. METHOD: This secondary analysis of the RECODE-HF cohort study analyzed baseline data of 3099 primary care heart failure patients aged 74 ± 10 years, 44.5 % female. Using multivariable regression, factors relating to medication and lifestyle adherence were investigated in order to estimate the extent to which these factors confound the association between psychological distress and adherence. RESULTS: Psychological distress was significantly associated with poorer medication adherence but not with lifestyle adherence after controlling for confounders. We identified different factors associated with medication compared to lifestyle adherence. A higher body mass index, a less developed social network, living alone, fewer chronic co-morbidities and unawareness of the heart failure diagnosis were only related to lower lifestyle adherence. Higher education was associated with poorer medication adherence. Male sex, younger age, lower self-efficacy and less familiar relation with the general practitioner were common factors associated with both lower medication and lifestyle adherence. CONCLUSION: Promising factors for increasing medication adherence (reduction of psychological distress) and lifestyle adherence (explaining the patient his/her heart failure diagnosis more than once and increase in the patients' self-efficacy), which were found in this cross-sectional study, must be further investigated in longitudinal studies.

AB - BACKGROUND: Psychological distress has a negative impact on the prognosis and quality of life for patients with heart failure. We investigated the association between psychological distress and the patients' adherence to medical treatment (medication adherence) and self-care advice (lifestyle adherence) in heart failure. We further examined whether there are different factors associated with low medication compared to low lifestyle adherence. METHOD: This secondary analysis of the RECODE-HF cohort study analyzed baseline data of 3099 primary care heart failure patients aged 74 ± 10 years, 44.5 % female. Using multivariable regression, factors relating to medication and lifestyle adherence were investigated in order to estimate the extent to which these factors confound the association between psychological distress and adherence. RESULTS: Psychological distress was significantly associated with poorer medication adherence but not with lifestyle adherence after controlling for confounders. We identified different factors associated with medication compared to lifestyle adherence. A higher body mass index, a less developed social network, living alone, fewer chronic co-morbidities and unawareness of the heart failure diagnosis were only related to lower lifestyle adherence. Higher education was associated with poorer medication adherence. Male sex, younger age, lower self-efficacy and less familiar relation with the general practitioner were common factors associated with both lower medication and lifestyle adherence. CONCLUSION: Promising factors for increasing medication adherence (reduction of psychological distress) and lifestyle adherence (explaining the patient his/her heart failure diagnosis more than once and increase in the patients' self-efficacy), which were found in this cross-sectional study, must be further investigated in longitudinal studies.

UR - https://www.scopus.com/pages/publications/85093907032

U2 - 10.1093/fampra/cmaa042

DO - 10.1093/fampra/cmaa042

M3 - Journal articles

C2 - 32358596

AN - SCOPUS:85093907032

SN - 0263-2136

VL - 37

SP - 695

EP - 702

JO - Family Practice

JF - Family Practice

IS - 5

ER -

Association of depression and anxiety with adherence in primary care patients with heart failure-cross-sectional results of the observational RECODE-HF cohort study

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