Association between depression and maintenance medication adherence among Medicare beneficiaries with chronic obstructive pulmonary disease

Jingjing Qian, Linda Simoni-Wastila, Gail B. Rattinger, Ilene H. Zuckerman, Susan Weinberger Lehmann, Yu Jung J Wei, Bruce Stuart

Research output: Contribution to journalArticle

Abstract

Objective Depression is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). Although comorbid depression is associated with low use and poor adherence to medications treating other chronic conditions, evidence of the relationship between depression and COPD management is limited. This study estimated the association between depression and COPD maintenance medication (MM) adherence among patients with COPD. Methods This cross-sectional study used a 5% random sample of 2006-2007 Chronic Condition Warehouse data. Medicare beneficiaries enrolled in Parts A, B, and D plans with diagnosed COPD who survived through 2006 were included (n = 74,863). COPD MM adherence was measured as medication discontinuation and proportion of days covered (PDC). Depression was identified through the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Multivariable models with modified generalized estimating equations were used to estimate adjusted association between depression diagnosis and medication adherence, controlling for sociodemographics, comorbidities, and disease severity. Results Among the sample, about one third (33.6%) had diagnosed depression. More than half (61.8%) of beneficiaries with COPD filled at least one COPD MM prescription. Depressed beneficiaries had a higher likelihood of using COPD MM than non-depressed beneficiaries (adjusted prevalence ratios [PR] = 1.02; 95% confidence intervals [CI] = 1.01, 1.03). Among COPD MM users, depressed beneficiaries were more likely to discontinue medications (PR = 1.09; 95% CI = 1.04, 1.14) and less likely to exhibit PDC ≥ 0.80 (PR = 0.89; 95% CI = 0.86, 0.92) than non-depressed beneficiaries. Conclusions Depression is prevalent in Medicare beneficiaries with COPD and independently associated with lower COPD MM adherence. Interventions to improve medication adherence for COPD patients may consider management of comorbidities such as depression.

Original languageEnglish (US)
Pages (from-to)49-57
Number of pages9
JournalInternational Journal of Geriatric Psychiatry
Volume29
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Medication Adherence
Medicare
Chronic Obstructive Pulmonary Disease
Maintenance
Depression
Comorbidity
Confidence Intervals
Levonorgestrel
International Classification of Diseases
Disease Management
Prescriptions
Cross-Sectional Studies

Keywords

  • chronic obstructive pulmonary disease
  • depression
  • maintenance medication
  • maintenance medication adherence
  • Medicare beneficiaries

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Association between depression and maintenance medication adherence among Medicare beneficiaries with chronic obstructive pulmonary disease. / Qian, Jingjing; Simoni-Wastila, Linda; Rattinger, Gail B.; Zuckerman, Ilene H.; Lehmann, Susan Weinberger; Wei, Yu Jung J; Stuart, Bruce.

In: International Journal of Geriatric Psychiatry, Vol. 29, No. 1, 01.2014, p. 49-57.

Research output: Contribution to journalArticle

Qian, Jingjing ; Simoni-Wastila, Linda ; Rattinger, Gail B. ; Zuckerman, Ilene H. ; Lehmann, Susan Weinberger ; Wei, Yu Jung J ; Stuart, Bruce. / Association between depression and maintenance medication adherence among Medicare beneficiaries with chronic obstructive pulmonary disease. In: International Journal of Geriatric Psychiatry. 2014 ; Vol. 29, No. 1. pp. 49-57.
@article{66ca523a7e8f4f9992ae6f57181972f2,
title = "Association between depression and maintenance medication adherence among Medicare beneficiaries with chronic obstructive pulmonary disease",
abstract = "Objective Depression is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). Although comorbid depression is associated with low use and poor adherence to medications treating other chronic conditions, evidence of the relationship between depression and COPD management is limited. This study estimated the association between depression and COPD maintenance medication (MM) adherence among patients with COPD. Methods This cross-sectional study used a 5{\%} random sample of 2006-2007 Chronic Condition Warehouse data. Medicare beneficiaries enrolled in Parts A, B, and D plans with diagnosed COPD who survived through 2006 were included (n = 74,863). COPD MM adherence was measured as medication discontinuation and proportion of days covered (PDC). Depression was identified through the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Multivariable models with modified generalized estimating equations were used to estimate adjusted association between depression diagnosis and medication adherence, controlling for sociodemographics, comorbidities, and disease severity. Results Among the sample, about one third (33.6{\%}) had diagnosed depression. More than half (61.8{\%}) of beneficiaries with COPD filled at least one COPD MM prescription. Depressed beneficiaries had a higher likelihood of using COPD MM than non-depressed beneficiaries (adjusted prevalence ratios [PR] = 1.02; 95{\%} confidence intervals [CI] = 1.01, 1.03). Among COPD MM users, depressed beneficiaries were more likely to discontinue medications (PR = 1.09; 95{\%} CI = 1.04, 1.14) and less likely to exhibit PDC ≥ 0.80 (PR = 0.89; 95{\%} CI = 0.86, 0.92) than non-depressed beneficiaries. Conclusions Depression is prevalent in Medicare beneficiaries with COPD and independently associated with lower COPD MM adherence. Interventions to improve medication adherence for COPD patients may consider management of comorbidities such as depression.",
keywords = "chronic obstructive pulmonary disease, depression, maintenance medication, maintenance medication adherence, Medicare beneficiaries",
author = "Jingjing Qian and Linda Simoni-Wastila and Rattinger, {Gail B.} and Zuckerman, {Ilene H.} and Lehmann, {Susan Weinberger} and Wei, {Yu Jung J} and Bruce Stuart",
year = "2014",
month = "1",
doi = "10.1002/gps.3968",
language = "English (US)",
volume = "29",
pages = "49--57",
journal = "International Journal of Geriatric Psychiatry",
issn = "0885-6230",
publisher = "John Wiley and Sons Ltd",
number = "1",

}

TY - JOUR

T1 - Association between depression and maintenance medication adherence among Medicare beneficiaries with chronic obstructive pulmonary disease

AU - Qian, Jingjing

AU - Simoni-Wastila, Linda

AU - Rattinger, Gail B.

AU - Zuckerman, Ilene H.

AU - Lehmann, Susan Weinberger

AU - Wei, Yu Jung J

AU - Stuart, Bruce

PY - 2014/1

Y1 - 2014/1

N2 - Objective Depression is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). Although comorbid depression is associated with low use and poor adherence to medications treating other chronic conditions, evidence of the relationship between depression and COPD management is limited. This study estimated the association between depression and COPD maintenance medication (MM) adherence among patients with COPD. Methods This cross-sectional study used a 5% random sample of 2006-2007 Chronic Condition Warehouse data. Medicare beneficiaries enrolled in Parts A, B, and D plans with diagnosed COPD who survived through 2006 were included (n = 74,863). COPD MM adherence was measured as medication discontinuation and proportion of days covered (PDC). Depression was identified through the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Multivariable models with modified generalized estimating equations were used to estimate adjusted association between depression diagnosis and medication adherence, controlling for sociodemographics, comorbidities, and disease severity. Results Among the sample, about one third (33.6%) had diagnosed depression. More than half (61.8%) of beneficiaries with COPD filled at least one COPD MM prescription. Depressed beneficiaries had a higher likelihood of using COPD MM than non-depressed beneficiaries (adjusted prevalence ratios [PR] = 1.02; 95% confidence intervals [CI] = 1.01, 1.03). Among COPD MM users, depressed beneficiaries were more likely to discontinue medications (PR = 1.09; 95% CI = 1.04, 1.14) and less likely to exhibit PDC ≥ 0.80 (PR = 0.89; 95% CI = 0.86, 0.92) than non-depressed beneficiaries. Conclusions Depression is prevalent in Medicare beneficiaries with COPD and independently associated with lower COPD MM adherence. Interventions to improve medication adherence for COPD patients may consider management of comorbidities such as depression.

AB - Objective Depression is a significant comorbidity in patients with chronic obstructive pulmonary disease (COPD). Although comorbid depression is associated with low use and poor adherence to medications treating other chronic conditions, evidence of the relationship between depression and COPD management is limited. This study estimated the association between depression and COPD maintenance medication (MM) adherence among patients with COPD. Methods This cross-sectional study used a 5% random sample of 2006-2007 Chronic Condition Warehouse data. Medicare beneficiaries enrolled in Parts A, B, and D plans with diagnosed COPD who survived through 2006 were included (n = 74,863). COPD MM adherence was measured as medication discontinuation and proportion of days covered (PDC). Depression was identified through the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. Multivariable models with modified generalized estimating equations were used to estimate adjusted association between depression diagnosis and medication adherence, controlling for sociodemographics, comorbidities, and disease severity. Results Among the sample, about one third (33.6%) had diagnosed depression. More than half (61.8%) of beneficiaries with COPD filled at least one COPD MM prescription. Depressed beneficiaries had a higher likelihood of using COPD MM than non-depressed beneficiaries (adjusted prevalence ratios [PR] = 1.02; 95% confidence intervals [CI] = 1.01, 1.03). Among COPD MM users, depressed beneficiaries were more likely to discontinue medications (PR = 1.09; 95% CI = 1.04, 1.14) and less likely to exhibit PDC ≥ 0.80 (PR = 0.89; 95% CI = 0.86, 0.92) than non-depressed beneficiaries. Conclusions Depression is prevalent in Medicare beneficiaries with COPD and independently associated with lower COPD MM adherence. Interventions to improve medication adherence for COPD patients may consider management of comorbidities such as depression.

KW - chronic obstructive pulmonary disease

KW - depression

KW - maintenance medication

KW - maintenance medication adherence

KW - Medicare beneficiaries

UR - http://www.scopus.com/inward/record.url?scp=84890128246&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84890128246&partnerID=8YFLogxK

U2 - 10.1002/gps.3968

DO - 10.1002/gps.3968

M3 - Article

C2 - 23606418

AN - SCOPUS:84890128246

VL - 29

SP - 49

EP - 57

JO - International Journal of Geriatric Psychiatry

JF - International Journal of Geriatric Psychiatry

SN - 0885-6230

IS - 1

ER -