TY - JOUR
T1 - Depressive symptom dimensions and medication non-adherence in suboptimally controlled type 2 diabetes
AU - Hoogendoorn, Claire J.
AU - Shapira, Amit
AU - Roy, Juan F.
AU - Walker, Elizabeth A.
AU - Cohen, Hillel W.
AU - Gonzalez, Jeffrey S.
N1 - Funding Information:
Grant support: This study was partially supported by the Einstein-Mount Sinai Diabetes Research Center ( P30 DK020541 ) and the New York Regional Center for Diabetes Translation Research ( P30 DK111022 ), as well as by grant R18 DK062038 from the National Institutes of Health . Dr. Hoogendoorn is also supported by the Drs. David and Jane Willner Bloomgarden Family Fellowship Fund. Dr. Gonzalez is supported by grants R01 DK104845 and R18 DK098742 from the National Institutes of Health .
Funding Information:
Grant support: This study was partially supported by the Einstein-Mount Sinai Diabetes Research Center (P30 DK020541) and the New York Regional Center for Diabetes Translation Research (P30 DK111022), as well as by grant R18 DK062038 from the National Institutes of Health. Dr. Hoogendoorn is also supported by the Drs. David and Jane Willner Bloomgarden Family Fellowship Fund. Dr. Gonzalez is supported by grants R01 DK104845 and R18 DK098742 from the National Institutes of Health.
Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2019/3
Y1 - 2019/3
N2 - Aims: Research suggests differential effects for somatic and cognitive-affective depressive symptoms in predicting health outcomes. This study evaluated differential relations with medication non-adherence among disadvantaged, and predominantly immigrant adults with sub-optimally controlled type 2 diabetes (T2D). Methods: Health plan members taking oral diabetes medication and who had A1c ≥ 7.5% were recruited for a trial of telephonic self-management support. A subset (n = 376; age, M = 55.6 ± 7.2 years; A1c M = 9.1% ± 1.6) completed the Patient Health Questionnaire-8 (PHQ-8). Diabetes medication adherence was measured by self-report and claims-based records. Multivariable logistic regression modeled depressive symptoms and odds of non-adherence using pre-intervention data. Results: A positive PHQ-8 screen (OR = 2.72 [95%CI: 1.56–4.73]) and each standard deviation increase in PHQ-8 score (OR = 1.40 [95%CI: 1.11–1.75]) were associated with non-adherence, with no independent effects for somatic versus cognitive-affective symptoms. Exploration of individual symptoms identified three significantly associated with non-adherence in covariate-adjusted models; after adjustment for likely presence of clinical depression, only fatigue was independently associated with non-adherence (OR = 1.71 [95%CI: 1.06–2.77]). Conclusions: Findings support depression symptom severity as a significant correlate of medication non-adherence among disadvantaged adults with T2D. Support was limited for differential associations for symptom dimensions, but findings suggest that fatigue may be associated with non-adherence independent of the likely presence of depression.
AB - Aims: Research suggests differential effects for somatic and cognitive-affective depressive symptoms in predicting health outcomes. This study evaluated differential relations with medication non-adherence among disadvantaged, and predominantly immigrant adults with sub-optimally controlled type 2 diabetes (T2D). Methods: Health plan members taking oral diabetes medication and who had A1c ≥ 7.5% were recruited for a trial of telephonic self-management support. A subset (n = 376; age, M = 55.6 ± 7.2 years; A1c M = 9.1% ± 1.6) completed the Patient Health Questionnaire-8 (PHQ-8). Diabetes medication adherence was measured by self-report and claims-based records. Multivariable logistic regression modeled depressive symptoms and odds of non-adherence using pre-intervention data. Results: A positive PHQ-8 screen (OR = 2.72 [95%CI: 1.56–4.73]) and each standard deviation increase in PHQ-8 score (OR = 1.40 [95%CI: 1.11–1.75]) were associated with non-adherence, with no independent effects for somatic versus cognitive-affective symptoms. Exploration of individual symptoms identified three significantly associated with non-adherence in covariate-adjusted models; after adjustment for likely presence of clinical depression, only fatigue was independently associated with non-adherence (OR = 1.71 [95%CI: 1.06–2.77]). Conclusions: Findings support depression symptom severity as a significant correlate of medication non-adherence among disadvantaged adults with T2D. Support was limited for differential associations for symptom dimensions, but findings suggest that fatigue may be associated with non-adherence independent of the likely presence of depression.
KW - Cognitive-affective symptoms
KW - Depression
KW - Medication adherence
KW - Somatic symptoms
KW - Type 2 diabetes
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U2 - 10.1016/j.jdiacomp.2018.12.001
DO - 10.1016/j.jdiacomp.2018.12.001
M3 - Article
C2 - 30598369
AN - SCOPUS:85059179583
VL - 33
SP - 217
EP - 222
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
SN - 1056-8727
IS - 3
ER -