Abstract
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.
| Original language | English (US) |
|---|---|
| Journal | Journal of Diabetes and its Complications |
| DOIs | |
| State | Accepted/In press - Jan 1 2018 |
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Keywords
- Cognitive-affective symptoms
- Depression
- Medication adherence
- Somatic symptoms
- Type 2 diabetes
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Endocrinology
Cite this
Depressive symptom dimensions and medication non-adherence in suboptimally controlled type 2 diabetes. / Hoogendoorn, Claire J.; Shapira, Amit; Roy, Juan F.; Walker, Elizabeth A.; Cohen, Hillel W.; Gonzalez, Jeffrey S.
In: Journal of Diabetes and its Complications, 01.01.2018.Research output: Contribution to journal › Article
}
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.
PY - 2018/1/1
Y1 - 2018/1/1
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
UR - http://www.scopus.com/inward/record.url?scp=85059179583&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85059179583&partnerID=8YFLogxK
U2 - 10.1016/j.jdiacomp.2018.12.001
DO - 10.1016/j.jdiacomp.2018.12.001
M3 - Article
C2 - 30598369
AN - SCOPUS:85059179583
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
SN - 1056-8727
ER -