Alomar Abdulrahman O, Khushaim Rakan H, Al-Ghanem Shahad K, Bin Jumaiah Abeer T, Albaqami Suhail M, Alleft Lujain A, Abahussain Eman A
College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.
Psychiatry, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU.
Cureus. 2024 Sep 14;16(9):e69418. doi: 10.7759/cureus.69418. eCollection 2024 Sep.
Background and aim Medication adherence is a crucial factor in the management of chronic diseases. Depression is a common psychiatric disorder that has been correlated with poor adherence to medication. Adherence to medication in patients with chronic diseases is a well-known concern among the medical community, particularly when considering the adverse outcomes of adherence failure in such patients. Therefore, this study aims to investigate the relationship between depression and medication adherence among chronic disease patients in the Middle East. Methodology This cross-sectional study was conducted between January 2024 and April 2024 among patients with chronic diseases from the Middle East. The data were collected through convenient sampling using structured online-based questionnaires that included demographic information, type of chronic condition, medication adherence (measured by the Adherence to Refills and Medications Scale (ARMS)), and depression severity (measured by the Patient Health Questionnaire-9 (PHQ-9)). Statistical analyses were conducted to examine the associations between these variables. Results The study involved 492 participants with chronic diseases and found significant associations between demographic factors and medication adherence. Female participants were more likely to be non-adherent than males (p = 0.001), and younger participants aged 20-30 years exhibited higher non-adherence rates (46.7%) compared to older participants, 61 years and above (16.1%, p = 0.001). Non-working individuals showed higher non-adherence (45.4%) compared to retired individuals (21.5%, p = 0.003). Depression severity was inversely related to medication adherence; participants with severe depression were significantly more likely to be non-adherent (relative risk (RR) = 8.41, 95% confidence interval (CI): 4.26-16.57, p < 0.001). In addition, certain chronic conditions were more impactful on medication adherence and depression rates, such as patients with rheumatoid disease that had lower rates of none to minimal depression (8.6%) and higher rates of moderately severe - severe depression each (28.6%). Meanwhile, asthma patients showed notably lower adherence rates (41.0%) and higher levels of severe depression (24.6%). Conclusion The study highlights the intricate relationships between demographic factors, chronic conditions, medication adherence, and depression in patients with chronic diseases in the Middle East. Gender, age, occupational status, and marital status significantly influence adherence and depression levels. Depression is a significant factor associated with decreased levels of adherence among patients with chronic conditions. Regular screening to detect and manage depression among chronically ill patients is advised to help improve medication adherence.
背景与目的 药物依从性是慢性病管理中的一个关键因素。抑郁症是一种常见的精神障碍，与药物依从性差有关。慢性病患者的药物依从性是医学界众所周知的一个问题，尤其是考虑到此类患者依从性失败的不良后果时。因此，本研究旨在调查中东慢性病患者中抑郁症与药物依从性之间的关系。
方法 本横断面研究于2024年1月至2024年4月在中东的慢性病患者中进行。通过便利抽样，使用基于网络的结构化问卷收集数据，问卷包括人口统计学信息、慢性病类型、药物依从性（通过药品续用和药物依从性量表（ARMS）测量）以及抑郁严重程度（通过患者健康问卷-9（PHQ-9）测量）。进行统计分析以检验这些变量之间的关联。
结果 该研究纳入了492名慢性病患者，发现人口统计学因素与药物依从性之间存在显著关联。女性参与者比男性更有可能不依从（p = 0.001），20至30岁的年轻参与者的不依从率（46.7%）高于61岁及以上的老年参与者（16.1%，p = 0.001）。无工作的个体比退休个体表现出更高的不依从率（45.4% 对 21.5%，p = 0.003）。抑郁严重程度与药物依从性呈负相关；重度抑郁症患者明显更有可能不依从（相对风险（RR）= 8.41，95%置信区间（CI）：4.26 - 16.57，p < 0.001）。此外，某些慢性病对药物依从性和抑郁率的影响更大，例如类风湿病患者无抑郁至轻度抑郁的比例较低（8.6%），中度严重 - 重度抑郁的比例各自较高（28.6%）。同时，哮喘患者的依从率明显较低（41.0%），重度抑郁水平较高（24.6%）。
结论 该研究突出了中东慢性病患者中人口统计学因素、慢性病、药物依从性和抑郁症之间的复杂关系。性别、年龄、职业状况和婚姻状况显著影响依从性和抑郁水平。抑郁症是慢性病患者依从性水平降低的一个重要相关因素。建议对慢性病患者进行定期筛查以检测和管理抑郁症，以帮助提高药物依从性。
