title: Depressive symptoms moderate the relationship between medication regimen complexity and objectively measured medication adherence in adults with heart failure.
abstract: Patients with heart failure (HF) take many medications to manage their HF and comorbidities, and 20-50% experience depression. Depressed individuals with more complex medication regimens may be at greater risk for poor adherence. The aim of this study was to assess depressive symptoms as a moderator of the relationship between medication regimen complexity and medication adherence in an observational study of patients with HF. In hierarchical linear regression with the final sample of 299, the interaction of medication regimen complexity and depressive symptoms predicted medication adherence, p < .05. For individuals with higher levels of depressive symptoms [1 standard deviation (SD) above the mean], more regimen complexity was associated with lower adherence. For individuals with low (1 SD below the mean) or average levels of depressive symptoms, regimen complexity was unrelated to medication adherence. Care management strategies, including pillboxes and caregiver involvement, may be valuable in HF patients with depression.
authors.affiliation: Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 196 Richmond Street, Providence, RI, 02903, USA. carly_goldstein@brown.edu.|The Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, RI, 02903, USA. carly_goldstein@brown.edu.
authors.forename: Carly M
authors.initials: CM
authors.lastname: Goldstein
authors.affiliation: Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, 196 Richmond Street, Providence, RI, 02903, USA.|Department of Psychological Sciences, Kent State University, Kent, OH, 44242, USA.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Gathright
authors.affiliation: Department of Psychological Sciences, Kent State University, Kent, OH, 44242, USA.
authors.forename: John
authors.initials: J
authors.lastname: Gunstad
authors.affiliation: School of Nursing, Case Western Reserve University, Cleveland, OH, 44106, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: A Dolansky
authors.affiliation: Summa Cardiovascular Institute, Akron City Hospital, Summa Health System, Akron, OH, 44307, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Redle
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA.|Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, 44106, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Josephson
authors.affiliation: School of Nursing, Case Western Reserve University, Cleveland, OH, 44106, USA.
authors.forename: Shirley M
authors.initials: SM
authors.lastname: Moore
authors.affiliation: Department of Psychological Sciences, Kent State University, Kent, OH, 44242, USA.|Summa Cardiovascular Institute, Akron City Hospital, Summa Health System, Akron, OH, 44307, USA.
authors.forename: Joel W
authors.initials: JW
authors.lastname: Hughes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged
keywords: Cardiovascular diseases; Depressive symptoms; Heart failure; Medication adherence; Self-care