The association of depression with adherence to antihypertensive medications: a systematic review.
The association of depression with adherence to antihypertensive medications: a systematic review.
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DOI：
10.1097/hjh.0b013e32833b4a6f
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发表时间：
2010-09
影响因子：
4.9
通讯作者：
Ziegelstein RC
中科院分区：
文献类型：
--
作者：
Eze-Nliam CM;Thombs BD;Lima BB;Smith CG;Ziegelstein RC
研究抑郁症与抗高血压药物依从性之间关系的证据的强度和一致性。检索MEDLINE、CINAHL、PsycINFO、Embase、SCOPUS和ISI数据库，从开始到2009年12月11日，检索已发表的原始研究，这些研究评估了抗高血压药物的依从性，并使用标准化访谈、有效问卷或国际疾病分类第九版（ICD-9）代码评估高血压患者的抑郁或抑郁症状。对22种选定期刊进行人工检索。使用Web of Science和Google Scholar跟踪纳入文章的引文。两名研究者独立地从所选文章中提取数据，并通过协商一致解决差异。确定了8项研究，共纳入42，790例患者。其中95%的患者来自一项研究。只有4项研究将这种关系的评估作为主要目的。依从率从29%到91%不等。研究内部和研究之间的结果差异很大。所有8项研究都报告了抑郁症与抗高血压药物依从性之间至少有一个显著的双变量或多变量负相关。8项研究中有6项报告了双变量或多变量分析的无意义结果。所有研究均报告了抑郁症与抗高血压药物依从性差之间的统计学显著关系，但由于研究之间在抑郁症和依从性评估方面存在实质性异质性，以及研究内和研究间结果不一致，因此无法得出明确结论。进一步的研究将有助于澄清这种关系。
To examine the strength and consistency of the evidence on the relationship between depression and adherence to antihypertensive medications. The MEDLINE, CINAHL, PsycINFO, Embase, SCOPUS, and ISI databases were searched from inception until December 11, 2009 for published studies of original research that assessed adherence to antihypertensive medications and used a standardized interview, validated questionnaire or International Classification of Diseases Ninth Revision (ICD-9) code to assess depression or symptoms of depression in patients with hypertension. Manual searching was conducted on 22 selected journals. Citations of included articles were tracked using Web of Science and Google Scholar. Two investigators independently extracted data from the selected articles and discrepancies were resolved by consensus. Eight studies were identified that included a total of 42,790 patients. 95% of these patients were from one study. Only 4 of the studies had the assessment of this relationship as a primary objective. Adherence rates varied from 29% to 91%. There were widely varying results within and across studies. All 8 studies reported at least one significant bivariate or multivariate negative relationship between depression and adherence to antihypertensive medications. Insignificant findings in bivariate or multivariate analyses were reported in 6 of 8 studies. All studies reported statistically significant relationships between depression and poor adherence to antihypertensive medications, but definitive conclusions cannot be drawn because of substantial heterogeneity between studies with respect to the assessment of depression and adherence, as well as inconsistencies in results both within and between studies. Additional studies would help clarify this relationship.