Depressed patients less likely to take their heart medications

LONDON: Patients, who feel low when having a cardiac device implanted, are more likely to stop taking their heart medications than those without depression, according to research presented at the ACNAP 2023, a scientific congress of the European Society of Cardiology (ESC) on Saturday.

An implantable cardioverter defibrillator (ICD) implantation is recommended for people at high risk of a life-threatening arrhythmia and for those who have had a sudden cardiac arrest.

It is estimated that approximately one in every five patients with an ICD is affected by depression or anxiety. Both mental health issues have been linked with an elevated risk of death in those with an ICD.

"Medications help to control symptoms and prevent further heart problems so adherence is important. Patients with an ICD who feel depressed or anxious should be encouraged to express their concerns, thoughts, and feelings and contact a health care professional who can screen them for distress to explore the best course of action," said Ole Skov, a psychologist and doctoral student in cardiac psychology at the University of Southern Denmark.

Most patients with an ICD are prescribed medication to manage their heart disease. Failure to take cardiac medications increases the risk of complications and death, making it crucial to identify patients who are more likely to stop taking their medication so that support measures can be initiated.

The study included 322 patients to examine whether anxiety and depression at the time of ICD implantation are associated with medication adherence one year after receiving the device.

The findings showed that patients with higher levels of depressive symptoms at the time of ICD implantation were less likely to be taking their heart medications one year later.

The effect of depression was statistically significant but small, which is not surprising given the complexity and multitude of factors involved in medication adherence, Skov said.

"These results highlight the importance of considering the psychological status of people receiving an ICD. Those with symptoms of depression at the time of implantation could be at risk of discontinuing their heart medications, even if they are taking them initially, and may need extra support," he added.