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Br J Psychiatry. 2015 Apr;206(4):297-301. doi: 10.1192/bjp.bp.114.155820. Epub 2015 Feb 5.

Adherence to antidepressant therapy and mortality rates in ischaemic heart disease: cohort study.

Author information

1
Amir Krivoy, MD, Clalit Research Institute, Tel Aviv, Geha Mental Health Center, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; Ran D. Balicer, MD, PhD, Clalit Research Institute, Tel Aviv, Public Health Department, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva; Becca Feldman, PhD, Moshe Hoshen, PhD, Clalit Research Institute, Tel Aviv, Israel; Gil Zalsman, MD, MHA, Geha Mental Health Center, Petah Tiqva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel, and Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, USA; Abraham Weizman, MD, Geha Mental Health Center, Petah Tiqva, Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv; Gal Shoval, MD, Clalit Research Institute, Tel Aviv, Geha Mental Health Center, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Abstract

BACKGROUND:

The use of antidepressant drugs in patients with ischaemic heart disease (IHD) has been debated owing to scarcity of data and conflicting results regarding the effect of these drugs on mortality.

AIMS:

To evaluate the association between adherence to antidepressant therapy and all-cause mortality in a population-based cohort of patients with IHD.

METHOD:

A total of 63 437 patients with IHD who purchased antidepressants at least once during the years 2008-2011 were retrospectively followed for all-cause mortality over 4 years. Adherence was measured as a ratio between claimed and prescribed durations of medication and modelled as non-adherence (<20%), poor (20-50%), moderate (50-80%) and good (>80%). We used multivariable survival analyses adjusted for demographic and clinical variables that may affect mortality.

RESULTS:

The moderate and good adherence groups had significantly reduced adjusted mortality hazard ratios of 0.83 (95% CI 0.78-0.88) and 0.86 (95% CI 0.82-0.90) respectively, compared with the non-adherence group.

CONCLUSIONS:

Adherence to antidepressant pharmacotherapy is associated with reduced all-cause mortality in a population-based large sample cohort of patients with IHD. Physicians and health policy decision-makers should step up their efforts to sustain and enhance these patients' adherence to their antidepressant regimen.

PMID:
25657353
DOI:
10.1192/bjp.bp.114.155820
[Indexed for MEDLINE]

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