The influence of gender, polypharmacy, anxiety, and depression on treatment adherence in patients with coronary heart disease and comorbid conditions

- Білоусова, Наталя Анатоліївна (orcid.org/0000-0001-6732-426X), Сіренко, Юрій Миколайович (orcid.org/0000-0002-4091-4910), Лучинська, Юлія Олександрівна (orcid.org/0009-0000-9468-8456), Яковенко, Людмила Іванівна (orcid.org/0009-0003-8811-8782) and Долженко, Марина Миколаївна (orcid.org/0000-0002-8559-9598) (2025) The influence of gender, polypharmacy, anxiety, and depression on treatment adherence in patients with coronary heart disease and comorbid conditions Hypertension and Cardiovascular Diseases, 1 (18). pp. 5-13. ISSN 2224-1485

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Abstract

Background. It is well established that the social consequences of non-adherence to treatment are significant: failure to adhere to pharmacotherapy is associated with 125,000 deaths annually in the USA and 194,500 in Europe. Given the rapid global increase in coronary heart disease (CHD) prevalence and the emerging clinical and economic benefits of adherence, addressing non-adherence to prescribed phar- macotherapy remains a top healthcare priority. The purpose was to retrospectively examine the potential influence of gender differences, polypharmacy, quality of life, anxiety, and depression on the model of adherence to treatment. The findings aim to enhance screening tools for identifying high-risk cardiac patients. Materials and methods. This study analyzed medical data from the Ukrainian cohort of patients who participated in the EUROASPIRE V observational study (2017–2018) in both hospital and outpatient settings. Results. Gender differences (B = –0.794; Exp(B) = 0.452; p = 0.044) were found to significantly impact treatment adherence, with women demonstrating a 54.8 % lower adherence rate compared to men. This finding suggests the need for gender-specific interventions to improve adherence. Polypharmacy at the first visit (B = 0.071, Exp(B) = 1.073, p = 0.594) did not show a significant association with adherence levels in CHD patients with comorbidities. Anxiety and depression were significantly more prevalent (p < 0.05) in the non-adherent group compared to the adherent one. The correlation between quality of life and anxiety/depression was very weak (0.039) and statistically insignificant (p > 0.05) in CHD patients with comorbidities over the study period (2017–2018). Conclusions. Polypharmacy prevalence in CHD pharmacotherapy was 76.47 % [76.44–76.50; p < 0.05], confirming the complexity of drug regimens used in CHD patients with comorbid conditions. An increased number of prescribed drugs at the second visit (B = 0.397, Exp(B) = 1.488, p < 0.05) negatively impacted adherence, reinforcing the need for fixed-dose combinations and simplified treatment regimens. The proposed logistic regression model, logit (P) = –1.629 – 0.794 × × gender + 0.071 × 1st visit + 0.397 × 2nd visit, supports the theo- retical validity of considering this model as descriptive.

Item Type:	Article
Keywords:	Coronary heart disease, arterial hypertension, quality of life, treatment adherence, anxiety, depression, polypharmacy
Subjects:	Science and knowledge. Organization. Computer science. Information. Documentation. Librarianship. Institutions. Publications > 3 Social Sciences > 305 Gender studies Science and knowledge. Organization. Computer science. Information. Documentation. Librarianship. Institutions. Publications > 6 Applied Sciences. Medicine. Technology > 61 Medical sciences
Divisions:	Institute of Pedagogical Education and Education for the Adults > Common resources institute
Depositing User:	ИПТО НАПН Natalia Bilousova
Date Deposited:	05 May 2025 09:12
Last Modified:	05 May 2025 09:12
URI:	https://lib.iitta.gov.ua/id/eprint/745208

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