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Antidepressant adherence and risk of coronary artery disease hospitalizations in older and younger adults with depression.

Abstract：

OBJECTIVES:To assess whether the relationship between antidepressant adherence and coronary artery disease (CAD) hospitalizations varied between older and younger adults with depression. DESIGN:Retrospective cohort study. SETTING:Department of Veterans Affairs outpatient clinics nationwide. PARTICIPANTS:Chronically depressed individuals (n = 50,261; aged 20-97) who had been prescribed an antidepressant were identified from records indicating an outpatient clinic visit for depression (index depression visit) during fiscal years 2009 and 2010. Individuals were considered chronically depressed if they had had prior depression visits and treatment for depression within the previous 4 months. The sample was age-stratified into younger (<65) and older (≥ 65) groups. MEASUREMENTS:After the index depression visit, medication possession ratios were calculated from pharmacy refill data to determine whether participants had 80% or greater adherence to antidepressant refills during a 6-month treatment observation period. International Classification of Diseases, Ninth Revision, codes were used to derive CAD-related hospitalizations during the follow-up period. Mean follow-up was 24 months. Data were analyzed using Cox proportional hazard models. RESULTS:Older participants with 80% or greater antidepressant adherence had 26% lower risk of CAD hospitalizations (hazard ratio = 0.74, 95% confidence interval = 0.60-0.93). Antidepressant adherence was not significantly related to CAD hospitalizations in younger adults. CONCLUSION:Older adults with chronic depression with 80% or greater antidepressant adherence had significantly lower risk of CAD hospitalizations at follow-up than those with less than 80% adherence. These preliminary results suggest that older adults with depression may derive cardiovascular benefits from clinical efforts to increase antidepressant adherence.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Cooper DC,Trivedi RB,Nelson KM,Reiber GE,Eugenio EC,Beaver KA,Fan VS

doi

10.1111/jgs.12849

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

1238-45

issue

eissn

0002-8614

issn

1532-5415

journal_volume

pub_type

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Antidepressant adherence and risk of coronary artery disease hospitalizations in older and younger adults with depression.