Depression and non-adherence to medications targeting treatable cardiovascular risk factors in the CONSTANCES cohort

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Hamieh, Nadine | Kab, Sofiane | Zins, Marie | Goldberg, Marcel | Melchior, Maria | Lemogne, Cédric

Edité par CCSD -

International audience. INTRODUCTION - Depression is associated with increased risk of cardiovascular disease but the mechanisms remain mostly unknown. OBJECTIVES - To study the association between depression and non-adherence to medications targeting type 2 diabetes, hypertension and dyslipidemia (i.e. treatable cardiovascular risk factors) in the Constances population-based French cohort. METHODS - We used Constances data linked to the French administrative health care database (SNDS) to study the longitudinal association between depression (assessed at inclusion with the Center for Epidemiological Studies Depression scale) and non-adherence to medications treating diabetes, hypertension and dyslipidemia over two subsequent periods of 18 months. Binary logistic regression models were adjusted for socio-demographics, body mass index, physical activity, prescribed and followed diet, and normal/abnormal levels of blood pressure, glycaemia, cholesterol and triglycerides at inclusion. RESULTS - Among 4,325 individuals with hypertension, 691 with diabetes and 3,329 with dyslipidemia, 535, 50 and 904 were non-adherent over the first 18 months, and 638, 65 and 1,207 between 19-36 months. Depression was neither associated with non-adherence to medications for hypertension and dyslipidemia over the first 18 months, nor afterwards. However, depression was associated with non-adherence to anti-diabetic medications (odds ratio [95% confidence interval]: 2.32 [1.19-4.52]) over the first 18 months only. Depression was only associated with uncontrolled dyslipidemia level (1.24 [1.02-1.52]), although a similar trend was observed for glycaemia level (1.45 [0.96-2.19]). CONCLUSIONS - In a population-based cohort, depression was only associated with non-adherence to anti-diabetic medications in the short run, thus urging clinicians to search for and treat depression in individuals with diabetes.

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