Relationship Between Depression and Medication Adherence in Older Patients With Cardiovascular Disease: A Systematic Review and Meta-Analysis.

BACKGROUND

Depression and cardiovascular disease (CVD) by the end of 2030 will be among the major causes of disability worldwide. Meanwhile, medication adherence is an important factor in predicting clinical outcomes in patients with CVD. Further, lack of medication compliance is affected by depression. Thus, this study aimed to explore the relationship between depression and medication adherence among older patients with CVD.

MATERIALS AND METHODS

The search was done across eight databases of PubMed/MEDLINE, Google Scholar, Embase, Scopus, APA Psycinfo, CINAHL/ebsco, ProQuest, and Web of Science. For the selection of included studies, there were no constraints regarding publication language. All studies available in each of the databases were searched up to December 9, 2021. Risk of bias assessment was done based on the Joanna Briggs Institute scale. The final result was estimated using a random effects model. The data were analyzed by CMA 2 software.

RESULTS

Seven studies and 10,153 elderly suffering from CVD were identified. Most included studies had reported an inverse association between depression and medication adherence. There was a small effect between depression and medication adherence among these older patients (combined odds ratio 0.603, 95% confidence interval 0.252-1.442). Thus, having depression would reduce medication adherence by 40%.

CONCLUSION

Depression has a considerable effect on medication adherence among older patients with CVD. Thus, it is suggested that considering the importance of depression and lack of medication adherence in increasing the negative outcomes of this disease in these patients, primary studies be conducted in this regard to achieve conclusive results in subsequent systematic reviews and meta-analyses.