Letter to the Editor: The Impact of Depression on Medication Compliance
Impact of Depression on Medication Compliance
The article published in the July 2012 issue of Clinical Geriatrics titled “Impact of Depression on Medication Compliance” (www.clinicalgeriatrics.com/articles/Impact-Depression-Medication-Compliance) presented a case report of medication noncompliance in an 85-year-old man that resulted from his depression. The significance of this growing issue should be given greater attention. It is estimated that about 1 in 5 women and 1 in 10 men will experience a depressive episode during their lifetime, with the rate of recurrence increasing with each successive depressive episode.1 Depression is recognized as one of the most serious and widely studied mental disorders, with presentations that can consist of lack of interest, loss of energy, fatigue, distorted thinking, and guilt.1,2 The impact of depressive symptoms can be viewed as a growing major health concern because of their potential detrimental effects on the quality of health and quality of life that can be experienced by sufferers of the disorder. There is the false belief that depression is a natural aspect of the aging process, and because clinical depression is prevalent in the elderly population, it should be immediately addressed in the same fashion as it would in any other patient population. The lack of proper attention being given to depression can affect functional status, quality of life, and mortality.3
Even though there are effective treatments for depressed elders, the majority of cases can go untreated or undertreated, which can negatively impact the management of other medical health conditions. There is the potential for medication errors to occur as a result of neglecting the presenting signs and symptoms of depression, which can ultimately contribute to medication noncompliance. The majority of patient-related errors among the elderly population often occur with hypoglycemic medications (28.7%), cardiovascular medications (21.7%), anticoagulants (18.6%), or diuretics (10.1%).4 It is imperative that the importance of medication compliance be communicated to an elderly patient with depressive symptoms as well as with his or her caregiver to decrease the likelihood of undue adverse effects.4 An awareness of the potential connection between depression and medication noncompliance in the elderly population will help clinicians to immediately identify and rectify this problem before it negatively impacts patient care.
Abimbola Farinde, PharmD
Lufkin State Supported Living Center
Dr. Farinde reports no relevant financial relationships.
1. Hersen M, Turner S, Beidel D, eds. Adult Psychopathology and Diagnosis. 5th ed. Hokoken, NJ: John Wiley & Sons, 2007.
2. Schatzberg AF, Cole JO, DeBattista C. Manual of Clinical Psychopharmacology. 7th ed. Arlington, VA: American Psychiatric Publishing Inc, 2010.
3. Ell K. Depression care for the elderly: reducing barriers to evidence based practice. Home Health Care Serv Q. 2006;25(1-2):115-148.
4. Field T, Mazor K, Briesacher B, Debellis KR, Gurwitz JH. Adverse drug events resulting from patient errors in older adults. J Am Geriatr Soc. 2007;55(2):271-276.