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The Psychosocial Context Impacts Medication Adherence After Acute Coronary Syndrome

Kronish, Ian M.; Rieckmann, Nina; Burg, Matthew M.; Alcantara, Carmela; Davidson, Karina W.

Background
Depression is associated with poor adherence to medications and worse prognosis in patients with acute coronary syndrome (ACS).
Purpose
To determine whether cognitive, behavioral, and/or psychosocial vulnerabilities for depression explain the association between depression and medication adherence among ACS patients.
Methods
One hundred sixty-nine ACS patients who agreed to have their aspirin adherence measured using an electronic pill bottle for 3 months were enrolled within 1 week of hospitalization. Linear regression was used to determine whether depression vulnerabilities predicted aspirin adherence after adjustment for depressive symptoms, demographics, and comorbidity.
Results
Of the depression vulnerabilities, only role transitions (beta = −3.32; P = 0.02) and interpersonal conflict (beta -3.78; P = 0.03) predicted poor adherence. Depression vulnerabilities did not mediate the association between depressive symptoms and medication adherence.
Conclusions
Key elements of the psychosocial context preceding the ACS including major role transitions and conflict with close contacts place ACS patients at increased risk for poor medication adherence independent of depressive symptoms.

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Also Published In

Title
Annals of Behavioral Medicine
DOI
https://doi.org/10.1007/s12160-013-9544-0

More About This Work

Academic Units
Center for Behavioral Cardiovascular Health
Social Work
Publisher
Springer
Published Here
May 20, 2016
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