Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients
Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients
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DOI：
10.1038/ki.2009.51
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发表时间：
2009-06-01
影响因子：
19.6
通讯作者：
Kimmel, Paul L.
中科院分区：
文献类型：
--
作者：
Cukor, Daniel;Rosenthal, Deborah S.;Kimmel, Paul L.
终末期肾病(ESRD)是一个日益严重的公共卫生问题，在这一人群中，不坚持治疗与较差的健康结局相关。抑郁症可能是这类患者最常见的精神病理，与发病率和死亡率的增加有关。我们比较了94名肾移植受者和65名在纽约布鲁克林一家主要医疗中心接受血液透析的患者的心理测量和自我报告的用药依从性。与移植组相比，根据贝克抑郁问卷评分，血液透析队列明显更抑郁。根据药物治疗依从性量表的报告，他们对药物的依从性也明显较低。使用分级多元回归分析，抑郁的方差是除性别和治疗方式外唯一具有统计学意义的药物依从性预测因子，占方差的12%。我们的研究强烈表明，抑郁情绪是血液透析或肾移植受者终末期肾病患者服药依从性低的重要原因。《国际肾脏》(2009年)75,1223-1229；doi：10.1038/ki.2009.51；在线发布
End-stage renal disease (ESRD) is a growing public health concern and non-adherence to treatment has been associated with poorer health outcomes in this population. Depression, likely to be the most common psychopathology in such patients, is associated with increased morbidity and mortality. We compared psychological measures and self-reported medication adherence of 94 kidney transplant recipients to those of 65 patients receiving hemodialysis in a major medical center in Brooklyn, New York. Compared to the transplant group, the hemodialysis cohort was significantly more depressed as determined by the Beck Depression Inventory score. They also had a significantly lower adherence to medication as reported on the Medication Therapy Adherence Scale. Using hierarchical multiple regression analysis, the variance in depression was the only statistically significant predictor of medication adherence beyond gender and mode of treatment, accounting for an additional 12% of the variance. Our study strongly suggests that a depressive affect is an important contributor to low medication adherence in patients with ESRD on hemodialysis or kidney transplant recipients. Kidney International (2009) 75, 1223-1229; doi:10.1038/ki.2009.51; published online 25 February 2009