Impact of post myocardial infarction depression on drug adherence of cardiological medicines

Background: Depressive symptoms are very usual in patients experiencing a history of myocardial infarction (MI). An individual who has developed depression after an episode of MI becomes non compliant with the treatment of cardiology. Aim: To test the impact of post MI depression on drug adherence of cardiological medicines. Settings and design: The study was conducted on patients of acute MI (n=50) attending cardiology outpatient department (OPD) of Assam Medical College and Hospital, Dibrugarh at eight weeks after the index event. Methods: Screening was performed by the Primary Care Evaluation of Mental Disorders (PRIME-MD) and diagnoses of major depressive disorder were established according to the text revision of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria. The eight-item Morisky Medication Adherence Questionnaire was applied to the patients to assess drug adherence after eight weeks from the MI episode. Results: Statistically significant strong association and correlation were found between post MI depression and drug adherence of cardiological medicines (Wald 9.84, Odd’s ratio 2.054, p=0.002, rho=0.714). Conclusion: The result of analysis has revealed that post MI depression has an unfavourable impact on drug adherence, ultimately contributing to increased risk of cardiological morbidity and death rate. Therefore, routine screening of depressive symptoms should be mandatory in cardiology.