Does Depression Impact Adherence in COPD Patients?

New onset of depression decreases adherence to maintenance medications in older adults with chronic obstructive pulmonary disease (COPD), according to the results of a recent study.

Depression is common in patients with COPD, and has been shown to decrease adherence to maintenance medications in other diseases, like diabetes. Despite this, little data are available on the role of depression in COPD medication adherence.
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To assess the potential impact, the researchers used a 5% random sample of Medicare administrative claims data to identify 31,033 individuals diagnoses with COPD from 2006 to 2010. Participants were including if they had filled at least 2 prescriptions for COPD maintenance medications following their diagnosis.

Overall, 6227 (20%) of the participants were diagnosed with depression following their COPD diagnosis. Average monthly adherence to COPD maintenance medications ranged from 57% in the month following the first prescription fill to 35% within 6 months. Patients with depression were less likely to adhere to COPD maintenance medications (OR 0.93; 95% CI 0.89, 0.98).

“New episodes of depression decreased adherence to maintenance medications used to manage COPD among older adults,” the researchers concluded.

“Clinicians who treat older adults with COPD should be aware of the development of depression, especially during the first six months following COPD diagnosis, and monitor patients’ adherence to prescribed COPD medications to ensure best clinical outcomes.”

—Michael Potts

Reference:

Albrecht JS., et al. Adherence to maintenance medications among older adults with chronic obstructive pulmonary disease: the role of depression [published online June 24, 2016]. Ann of Am Thor Soc. DOI: 10.1513/AnnalsATS.201602-136OC.