British Journal of Health Psychology

Volume 26, Issue 3 p. 748-766

Original article

Depression, anxiety, perceived stress, and their changes predicted medical adherence over 9 months among patients with coronary heart disease

Yunge Fan,

Yunge Fan

Psychology Program, Nanyang Technological University, Singapore City, Singapore

Search for more papers by this author

Biing-Jiun Shen,

Corresponding Author

Biing-Jiun Shen

[email protected]

Psychology Program, Nanyang Technological University, Singapore City, Singapore

Correspondence should be addressed to Biing-Jiun Shen, Psychology Program, Nanyang Technological University, 48 Nanyang Drive, Singapore City 639818, Singapore (email: [email protected]).

Search for more papers by this author

Hung Yong Tay,

Hung Yong Tay

Heart Wellness Center, Singapore Heart Foundation, Singapore City, Singapore

Search for more papers by this author

Yunge Fan,

Yunge Fan

Psychology Program, Nanyang Technological University, Singapore City, Singapore

Search for more papers by this author

Biing-Jiun Shen,

Corresponding Author

Biing-Jiun Shen

[email protected]

Psychology Program, Nanyang Technological University, Singapore City, Singapore

Correspondence should be addressed to Biing-Jiun Shen, Psychology Program, Nanyang Technological University, 48 Nanyang Drive, Singapore City 639818, Singapore (email: [email protected]).

Search for more papers by this author

Hung Yong Tay,

Hung Yong Tay

Heart Wellness Center, Singapore Heart Foundation, Singapore City, Singapore

Search for more papers by this author

First published: 31 December 2020

https://doi.org/10.1111/bjhp.12496

Citations: 3

Read the full text

About

PDF

Tools

Share a link

Email
Facebook
Twitter
LinkedIn
Reddit
Wechat

Abstract

Objectives

Although effective medical treatments have proved to successfully improve prognoses and outcomes of patients with coronary heart disease (CHD), low adherence to treatments is still common among patients. Deleterious impact of psychological distress on medical adherence has been recognized; however, few studies examined the influence of change in psychological distress on attenuation in adherence. This study investigated whether three common manifestations of distress (depression, anxiety, and perceived stress) and their changes predicted decline in medical adherence among CHD patient over 9 months.

Design

A three-wave longitudinal study.

Methods

Participants were 255 CHD patients with a mean age of 63 years. Psychological distress, medication adherence, and specific treatment adherence were assessed at baseline, 3 months, and 9 months. Hierarchical regression analyses were conducted to examine the influences of psychological distress on medical adherence over 9 months. All models were adjusted for baseline medication or specific adherence, demographic, and medical covariates.

Results

Baseline depression and its changes over time significantly predicted greater decline in both medication adherence (βs = .15–.20, ps < .05) and specific adherence (βs = −.21 to −.15, ps < .05). Anxiety showed a similar trend. For perceived stress, baseline and its change significantly predicted specific adherence over 9 months (βs = −.30 to −.23, ps < .01), but did not predict medication adherence at 3 and 9 months.

Conclusions

Findings underline the necessity of tracking various forms of psychological distress over time for CHD patients to promote medical adherence and further improve the disease prognosis.

Conflicts of interest

All authors declare no conflict of interest.

Open Research

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Supporting Information

REFERENCES

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5^®). Philadelphia, PA: American Psychiatric Pub.
10.1176/appi.books.9780890425596
Google Scholar
Booth, III, J. N., Levitan, E. B., Brown, T. M., Farkouh, M. E., Safford, M. M., & Muntner, P. (2014). Effect of sustaining lifestyle modifications (nonsmoking, weight reduction, physical activity, and mediterranean diet) after healing of myocardial infarction, percutaneous intervention, or coronary bypass (from the REasons for Geographic and Racial Differences in Stroke Study). The American Journal of Cardiology, 113, 1933–1940. https://doi.org/10.1016/j.amjcard.2014.03.033
10.1016/j.amjcard.2014.03.033
PubMedWeb of Science®Google Scholar
Chiang, C. Y., Choi, K. C., Ho, K. M., & Yu, S. F. (2018). Effectiveness of nurse-led patient-centered care behavioral risk modification on secondary prevention of coronary heart disease: A systematic review. International Journal of Nursing Studies, 84, 28–39. https://doi.org/10.1016/j.ijnurstu.2018.04.012
10.1016/j.ijnurstu.2018.04.012
PubMedWeb of Science®Google Scholar
Chiuve, S. E., Fung, T. T., Rexrode, K. M., Spiegelman, D., Manson, J. E., Stampfer, M. J., & Albert, C. M. (2011). Adherence to a low-risk, healthy lifestyle and risk of sudden cardiac death among women. JAMA, 306(1), 62–69. https://doi.org/10.1001/jama.2011.907
10.1001/jama.2011.907
CASPubMedWeb of Science®Google Scholar
Chowdhury, R., Khan, H., Heydon, E., Shroufi, A., Fahimi, S., Moore, C., … Franco, O. H. (2013). Adherence to cardiovascular therapy: A meta-analysis of prevalence and clinical consequences. European Heart Journal, 34, 2940–2948. https://doi.org/10.1093/eurheartj/eht295
10.1093/eurheartj/eht295
CASPubMedWeb of Science®Google Scholar
Cohen, S., Kamarck, T., & Mermelstein, R. (1994). Perceived stress scale. In Measuring stress: A guide for health and social scientists, New York: Oxford University Press.

Google Scholar
Cohen, S., Tyrrell, D. A., & Smith, A. P. (1993). Negative life events, perceived stress, negative affect, and susceptibility to the common cold. Journal of Personality and Social Psychology, 64(1), 131–140. https://doi.org/10.1037//0022-3514.64.1.131
10.1037/0022-3514.64.1.131
CASPubMedWeb of Science®Google Scholar
Cohen, S., & Williamson, G. (1988). Perceived stress in a probability sample of the U.S. In S. Spacapam & S. Oskamp (Eds.), The social psychology of health: Claremont Symposium on Applied Social Psychology (pp. 31–67). Newbury Park, CA: Sage.

Google Scholar
DiMatteo, M. R., Sherbourne, C. D., Hays, R. D., Ordway, L., Kravitz, R. L., McGlynn, E. A., … Rogers, W. H. (1993). Physicians' characteristics influence patients' adherence to medical treatment: Results from the Medical Outcomes Study. Health Psychology, 12, 93–102. https://doi.org/10.1037/0278-6133.12.2.93
10.1037/0278-6133.12.2.93
CASPubMedWeb of Science®Google Scholar
Ebner-Priemer, U. W., Eid, M., Kleindienst, N., Stabenow, S., & Trull, T. J. (2009). Analytic strategies for understanding affective (in)stability and other dynamic processes in psychopathology. Journal of Abnormal Psychology, 118(1), 195–202. https://doi.org/10.1037/a0014868
10.1037/a0014868
PubMedWeb of Science®Google Scholar
Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., … Williams, S. V. (2012). 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease: A report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation, 126, e354–e471. https://doi.org/10.1161/CIR.0b013e318277d6a0
10.1161/CIR.0b013e318277d6a0
PubMedWeb of Science®Google Scholar
Global Health Estimates 2016 (2018). Deaths by cause, age, sex, by country and by region, 2000-2016. World Health Organization. Retrieved from http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html

Google Scholar
Graham, I., Atar, D., Borch-Johnsen, K., Boysen, G., Burell, G., Cifkova, R., … Zamorano, J. L. (2007). European guidelines on cardiovascular disease prevention in clinical practice: Executive summary. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). European Journal of Cardiovascular Prevention and Rehabilitation, 14(2_suppl), E1–E40. https://doi.org/10.1097/01.hjr.0000277984.31558.c4
10.1097/01.hjr.0000277984.31558.c4
PubMedGoogle Scholar
Hybels, C. F., Pieper, C. F., Blazer, D. G., & Steffens, D. C. (2016). Heterogeneity in the three-year course of major depression among older adults. International Journal of Geriatric Psychiatry, 31, 775–782. https://doi.org/10.1002/gps.4391
10.1002/gps.4391
PubMedWeb of Science®Google Scholar
Janssen, V., De Gucht, V., Dusseldorp, E., & Maes, S. (2013). Lifestyle modification programmes for patients with coronary heart disease: A systematic review and meta-analysis of randomized controlled trials. European Journal of Preventive Cardiology, 20, 620–640. https://doi.org/10.1177/2047487312462824
10.1177/2047487312462824
PubMedWeb of Science®Google Scholar
Kahkonen, O., Saaranen, T., Kankkunen, P., Lamidi, M. L., Kyngas, H., & Miettinen, H. (2018). Predictors of adherence to treatment by patients with coronary heart disease after percutaneous coronary intervention. Journal of Clinical Nursing, 27(5–6), 989–1003. https://doi.org/10.1111/jocn.14153
10.1111/jocn.14153
PubMedWeb of Science®Google Scholar
Khera, A. V., Emdin, C. A., Drake, I., Natarajan, P., Bick, A. G., Cook, N. R., … Kathiresan, S. (2016). Genetic risk, adherence to a healthy lifestyle, and coronary disease. New England Journal of Medicine, 375, 2349–2358. https://doi.org/10.1056/NEJMoa1605086
10.1056/NEJMoa1605086
CASPubMedWeb of Science®Google Scholar
Knight, R. G., Williams, S., McGee, R., & Olaman, S. (1997). Psychometric properties of the Centre for Epidemiologic Studies Depression Scale (CES-D) in a sample of women in middle life. Behaviour Research and Therapy, 35(4), 373–380. https://doi.org/10.1016/S0005-7967(96)00107-6
10.1016/S0005-7967(96)00107-6
CASPubMedWeb of Science®Google Scholar
Knoops, K. T., de Groot, L. C., Kromhout, D., Perrin, A. E., Moreiras-Varela, O., Menotti, A., & van Staveren, W. A. (2004). Mediterranean diet, lifestyle factors, and 10-year mortality in elderly European men and women: The HALE project. JAMA, 292, 1433–1439. https://doi.org/10.1001/jama.292.12.1433
10.1001/jama.292.12.1433
PubMedWeb of Science®Google Scholar
Krack, G., Holle, R., Kirchberger, I., Kuch, B., Amann, U., & Seidl, H. (2018). Determinants of adherence and effects on health-related quality of life after myocardial infarction: A prospective cohort study. BMC Geriatrics, 18(1), 136. https://doi.org/10.1186/s12877-018-0827-y
10.1186/s12877-018-0827-y
PubMedWeb of Science®Google Scholar
Kripalani, S., Risser, J., Gatti, M. E., & Jacobson, T. A. (2009). Development and evaluation of the Adherence to Refills and Medications Scale (ARMS) among low-literacy patients with chronic disease. Value in Health, 12(1), 118–123. https://doi.org/10.1111/j.1524-4733.2008.00400.x
10.1111/j.1524-4733.2008.00400.x
CASPubMedWeb of Science®Google Scholar
Leon, A. S., Franklin, B. A., Costa, F., Balady, G. J., Berra, K. A., Stewart, K. J., … Lauer, M. S. (2005). Cardiac rehabilitation and secondary prevention of coronary heart disease: An American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation. Circulation, 111, 369–376. https://doi.org/10.1161/01.CIR.0000151788.08740.5C
10.1161/01.CIR.0000151788.08740.5C
PubMedWeb of Science®Google Scholar
Lin, E. H. B., Von Korff, M., Ciechanowski, P., Peterson, D., Ludman, E. J., Rutter, C. M., … Katon, W. J. (2012). Treatment adjustment and medication adherence for complex patients with diabetes, heart disease, and depression: A randomized controlled trial. Annals of Family Medicine, 10(1), 6–14. https://doi.org/10.1370/afm.1343
10.1370/afm.1343
PubMedWeb of Science®Google Scholar
Luyster, F. S., Hughes, J. W., & Gunstad, J. (2009). Depression and anxiety symptoms are associated with reduced dietary adherence in heart failure patients treated with an implantable cardioverter defibrillator. Journal of Cardiovascular Nursing, 24(1), 10–17. https://doi.org/10.1097/01.JCN.0000317469.63886.24
10.1097/01.JCN.0000317469.63886.24
PubMedWeb of Science®Google Scholar
Niles, A. N., Dour, H. J., Stanton, A. L., Roy-Byrne, P. P., Stein, M. B., Sullivan, G., … Craske, M. G. (2015). Anxiety and depressive symptoms and medical illness among adults with anxiety disorders. Journal of Psychosomatic Research, 78(2), 109–115. https://doi.org/10.1016/j.jpsychores.2014.11.018
10.1016/j.jpsychores.2014.11.018
PubMedWeb of Science®Google Scholar
Olafiranye, O., Jean-Louis, G., Zizi, F., Nunes, J., & Vincent, M. (2011). Anxiety and cardiovascular risk: Review of Epidemiological and Clinical Evidence. Mind & Brain, 2(1), 32–37.

CASPubMedGoogle Scholar
Pedersen, S. S., von Kanel, R., Tully, P. J., & Denollet, J. (2017). Psychosocial perspectives in cardiovascular disease. European Journal of Preventive Cardiology, 24(3_suppl), 108–115. https://doi.org/10.1177/2047487317703827
10.1177/2047487317703827
PubMedWeb of Science®Google Scholar
Perk, J., Hambraeus, K., Burell, G., Carlsson, R., Johansson, P., & Lisspers, J. (2015). Study of Patient Information after percutaneous Coronary Intervention (SPICI): Should prevention programmes become more effective? EuroIntervention, 10(11), e1–e7. https://doi.org/10.4244/EIJV10I11A223
10.4244/EIJV10I11A223
PubMedWeb of Science®Google Scholar
Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. https://doi.org/10.1177/014662167700100306
10.1177/014662167700100306
PubMedWeb of Science®Google Scholar
Radloff, L. S., & Locke, B. Z. (1986). The community mental health assessment survey and the CES-D scale. Community Surveys of Psychiatric Disorders, 4, 177–188.

Google Scholar
Roshanaei-Moghaddam, B., Katon, W. J., & Russo, J. (2009). The longitudinal effects of depression on physical activity. General Hospital Psychiatry, 31(4), 306–315. https://doi.org/10.1016/j.genhosppsych.2009.04.002
10.1016/j.genhosppsych.2009.04.002
PubMedWeb of Science®Google Scholar
Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors. Applied Psychology, 57(1), 1–29. https://doi.org/10.1111/j.1464-0597.2007.00325.x
10.1111/j.1464-0597.2007.00325.x
Web of Science®Google Scholar
Sherbourne, C. D., Hays, R. D., Ordway, L., DiMatteo, M. R., & Kravitz, R. L. (1992). Antecedents of adherence to medical recommendations: Results from the Medical Outcomes Study. Journal of Behavioral Medicine, 15(5), 447–468. https://doi.org/10.1007/BF00844941
10.1007/BF00844941
CASPubMedWeb of Science®Google Scholar
Sin, N. L., Kumar, A. D., Gehi, A. K., & Whooley, M. A. (2016). Direction of association between depressive symptoms and lifestyle behaviors in patients with coronary heart disease: The Heart and Soul Study. Annals of Behavioral Medicine, 50, 523–532. https://doi.org/10.1007/s12160-016-9777-9
10.1007/s12160-016-9777-9
PubMedWeb of Science®Google Scholar
Sin, N. L., Moskowitz, J. T., & Whooley, M. A. (2015). Positive affect and health behaviors across 5 years in patients with coronary heart disease: The heart and soul study. Psychosomatic Medicine, 77, 1058–1066. https://doi.org/10.1097/PSY.0000000000000238
10.1097/PSY.0000000000000238
PubMedWeb of Science®Google Scholar
Smith, S. C., Benjamin, E. J., Bonow, R. O., Braun, L. T., Creager, M. A., Franklin, B. A., … Taubert, K. A. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124, 2458–2473. https://doi.org/10.1161/CIR.0b013e318235eb4d
10.1161/CIR.0b013e318235eb4d
PubMedWeb of Science®Google Scholar
Su, M., Haldane, V., Upshur, R., Sullivan, F., Legare, F., Greiver, M., & Wei, X. (2019). The impact of treatment adherence for patients with diabetes and hypertension on cardiovascular disease risk: Protocol for a Retrospective Cohort Study, 2008–2018. JMIR Res Protoc, 8(5), e13571. https://doi.org/10.2196/13571
10.2196/13571
PubMedWeb of Science®Google Scholar
Swardfager, W., Herrmann, N., Marzolini, S., Saleem, M., Farber, S. B., Kiss, A., … Lanctôt, K. L. (2011). Major depressive disorder predicts completion, adherence, and outcomes in cardiac rehabilitation: A prospective cohort study of 195 patients with coronary artery disease. Journal of Clinical Psychiatry, 72, 1181–1188. https://doi.org/10.4088/JCP.09m05810blu
10.4088/JCP.09m05810blu
PubMedWeb of Science®Google Scholar
Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach's alpha. International Journal of Medical Education, 2, 53–55. https://doi.org/10.5116/ijme.4dfb.8dfd
10.5116/ijme.4dfb.8dfd
PubMedGoogle Scholar
Trichopoulou, A., Costacou, T., Bamia, C., & Trichopoulos, D. (2003). Adherence to a Mediterranean diet and survival in a Greek population. New England Journal of Medicine, 348, 2599–2608. https://doi.org/10.1056/NEJMoa025039
10.1056/NEJMoa025039
PubMedWeb of Science®Google Scholar
Vik, S. A., Maxwell, C. J., & Hogan, D. B. (2004). Measurement, correlates, and health outcomes of medication adherence among seniors. Annals of Pharmacotherapy, 38, 303–312. https://doi.org/10.1345/aph.1D252
10.1345/aph.1D252
PubMedWeb of Science®Google Scholar
Ye, X., Gross, C. R., Schommer, J., Cline, R., & St Peter, W. L. (2007). Association between copayment and adherence to statin treatment initiated after coronary heart disease hospitalization: A longitudinal, retrospective, cohort study. Clinical Therapeutics, 29, 2748–2757. https://doi.org/10.1016/j.clinthera.2007.12.022
10.1016/j.clinthera.2007.12.022
PubMedWeb of Science®Google Scholar
Ziegelstein, R. C., Fauerbach, J. A., Stevens, S. S., Romanelli, J., Richter, D. P., & Bush, D. E. (2000). Patients with depression are less likely to follow recommendations to reduce cardiac risk during recovery from a myocardial infarction. Archives of Internal Medicine, 160, 1818–1823. https://doi.org/10.1001/archinte.160.12.1818
10.1001/archinte.160.12.1818
CASPubMedWeb of Science®Google Scholar
Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
10.1111/j.1600-0447.1983.tb09716.x
CASPubMedWeb of Science®Google Scholar

Citing Literature

Volume26, Issue3

September 2021

Pages 748-766

Depression, anxiety, perceived stress, and their changes predicted medical adherence over 9 months among patients with coronary heart disease

Abstract

Objectives

Design

Methods

Results

Conclusions

Conflicts of interest

Open Research

Data availability statement

Supporting Information

REFERENCES

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Depression, anxiety, perceived stress, and their changes predicted medical adherence over 9 months among patients with coronary heart disease

Abstract

Objectives

Design

Methods

Results

Conclusions

Conflicts of interest

Open Research

Data availability statement

Supporting Information

REFERENCES

Citing Literature

References

Related

Information