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Emotional Distress as a Predictor of Statin Non-adherence among Swedish First-Time Myocardial Infarction Patients, 2006–2013
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Clinical Psychology in Healthcare.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Clinical Psychology in Healthcare.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.ORCID iD: 0000-0001-9402-7404
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Clinical Psychology in Healthcare.ORCID iD: 0000-0002-1591-7407
2017 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 97, 30-37 p.Article in journal (Refereed) Published
Abstract [en]

Background: Emotional distress (depression and anxiety) has been known to affect mortality after a myocardial infarction (MI). One possible mechanism is through medication non-adherence. Few studies have investigated the link between statin adherence and emotional distress, and results are not consistent. We aimed to explore whether emotional distress affects adherence among first-time MI patients younger than 75 years old receiving a prescription for the first time.

Methods: We identified first-MI individuals younger than 75 years from the SWEDEHEART national quality registers discharged with a statin prescription. The main exposure was the anxiety/depression portion of the EQ-5D from Interview 1 (6-10 weeks post -MI) and Interview 2 (12-14 months post -MI). We calculated adherence from the Swedish Prescribed Drugs Register during three observation periods (OP): [1] Interview 1 to Interview 2, [2] one year post Interview 2, and [3] two years post Interview 1.

Results: Emotional distress at Interview 1 was not associated with statin adherence for OP1 (RR: 0.99, 95% CI: 0.98, 1.01). Emotional distress at Interview 2 was associated with lower adherence one year later (RR: 0.95, 95% CI: 0.93, 0.98). Emotional distress at Interview 1 was associated with a small decrease in adherence in the complete OP for adherence (RR: 0.98, 95% CI: 0.96, 0.99).

Conclusion: Emotional distress was marginally, but independently, associated with lower adherence to statin two years after the MI. Our study suggests that emotional distress may be an important factor for long-term statin adherence, and, thus, may play a clinically important role in long-term outcome.

Place, publisher, year, edition, pages
2017. Vol. 97, 30-37 p.
Keyword [en]
Statins, Emotional Distress, Depression, Anxiety, Adherence, SWEDEHEART, Medication Rossession Ratio
National Category
Psychology Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-316572DOI: 10.1016/j.jpsychores.2017.02.015ISI: 000403523800005PubMedID: 28606496OAI: oai:DiVA.org:uu-316572DiVA: diva2:1078283
Conference
The American Heart Association’s Scientific Sessions 2016
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4947Vårdal Foundation, 2014-0114
Available from: 2017-03-03 Created: 2017-03-03 Last updated: 2017-09-21Bibliographically approved

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Lissåker, Claudia T.Wallert, JohnHeld, ClaesOlsson, Erik

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