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

作者：Krivoy Amir^*; Balicer Ran D; Feldman Becca; Hoshen Moshe; Zalsman Gil; Weizman Abraham; Shoval Gal

来源：The British Journal of Psychiatry, 2015, 206(4): 297-301.

DOI：10.1192/bjp.bp.114.155820

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% Cl 0.78-0.88) and 0.86 (95% Cl 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.

• 出版日期2015-4
• 单位上海市精神卫生中心