The role of depression, anxiety, and stress in medication adherence in patients with hypertension

Abstract

Background: Despite the importance of psychological factors in adherence to the treatment in patients with hypertension, a few studies have been done to identify the factors affecting adherence to treatment and particularly to investigate the role of psychology factors in Iranian population. This study aimed to investigate the role of mental health in adherence to medication in patients with hypertension in rural areas of Isfahan Province, Iran. Methods: In this cross-sectional study, 300 patients with hypertension were studied. Multistage sampling was performed in health centers. Data collection tools included depression, anxiety and stress scale (DASS) short form and the Morisky 8-items medication adherence questionnaire. The odds ratio (OR) for different levels of depression, anxiety, and stress in both groups with appropriate adherence and non-appropriate adherence to treatment were determined. We used multivariate logistic regression model for statistical analysis. Findings: Patients with very severe levels of anxiety were more non-adherent to drug therapy than those with normal levels of anxiety (OR = 2.8; CI95: 1.07-7.38). While other levels of anxiety and severity of depression and stress were not significant predictors for predicting patients’ adherence to treatment. Conclusion: Understanding the severity of depression, stress, and anxiety to ensure adherence and treatment outcomes in patients with hypertension are essential. According to this study, very severe anxiety can be considered as an important predicting factor in the lack of adherence to medication. © 2017, Isfahan University of Medical Sciences(IUMS). All rights reserved.