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Depression and Diabetes Treatment Nonadherence: A Meta-Analysis
OBJECTIVE—Depression is common in patients with diabetes and is associated with worse treatment outcomes. Its relationship to treatment adherence, however, has not been systematically reviewed. We used meta-analysis to examine the relationship between depression and treatment nonadherence in patient...
Autores principales: | , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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American Diabetes Association
2008
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584202/ https://www.ncbi.nlm.nih.gov/pubmed/19033420 http://dx.doi.org/10.2337/dc08-1341 |
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author | Gonzalez, Jeffrey S. Peyrot, Mark McCarl, Lauren A. Collins, Erin Marie Serpa, Luis Mimiaga, Matthew J. Safren, Steven A. |
author_facet | Gonzalez, Jeffrey S. Peyrot, Mark McCarl, Lauren A. Collins, Erin Marie Serpa, Luis Mimiaga, Matthew J. Safren, Steven A. |
author_sort | Gonzalez, Jeffrey S. |
collection | PubMed |
description | OBJECTIVE—Depression is common in patients with diabetes and is associated with worse treatment outcomes. Its relationship to treatment adherence, however, has not been systematically reviewed. We used meta-analysis to examine the relationship between depression and treatment nonadherence in patients with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS—We searched MEDLINE and PsycINFO databases for all studies published by June 2007 and reviewed references of published articles. Meta-analytic procedures were used to estimate the effect size r in a random effects model. Significance values, weighted effect sizes, 95% CIs, and tests of homogeneity of variance were calculated. RESULTS—Results from 47 independent samples showed that depression was significantly associated with nonadherence to the diabetes treatment regimen (z = 9.97, P < 0.0001). The weighted effect size was near the medium range (r = 0.21, 95% CI 0.17–0.25). Moderator analyses showed that the effect was significantly larger in studies that measured self-care as a continuous versus categorical variable (P = 0.001). Effect sizes were largest for missed medical appointments and composite measures of self-care (r values = 0.31, 0.29). Moderation analyses suggest that effects for most other types of self-care are also near the medium range, especially in studies with stronger methodologies. CONCLUSIONS—These findings demonstrate a significant association between depression and treatment nonadherence in patients with diabetes. Studies that used stronger methodologies had larger effects. Treatment nonadherence may represent an important pathway between depression and worse diabetes clinical outcomes. |
format | Text |
id | pubmed-2584202 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | American Diabetes Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-25842022009-12-01 Depression and Diabetes Treatment Nonadherence: A Meta-Analysis Gonzalez, Jeffrey S. Peyrot, Mark McCarl, Lauren A. Collins, Erin Marie Serpa, Luis Mimiaga, Matthew J. Safren, Steven A. Diabetes Care Reviews/Commentaries/ADA Statements OBJECTIVE—Depression is common in patients with diabetes and is associated with worse treatment outcomes. Its relationship to treatment adherence, however, has not been systematically reviewed. We used meta-analysis to examine the relationship between depression and treatment nonadherence in patients with type 1 and type 2 diabetes. RESEARCH DESIGN AND METHODS—We searched MEDLINE and PsycINFO databases for all studies published by June 2007 and reviewed references of published articles. Meta-analytic procedures were used to estimate the effect size r in a random effects model. Significance values, weighted effect sizes, 95% CIs, and tests of homogeneity of variance were calculated. RESULTS—Results from 47 independent samples showed that depression was significantly associated with nonadherence to the diabetes treatment regimen (z = 9.97, P < 0.0001). The weighted effect size was near the medium range (r = 0.21, 95% CI 0.17–0.25). Moderator analyses showed that the effect was significantly larger in studies that measured self-care as a continuous versus categorical variable (P = 0.001). Effect sizes were largest for missed medical appointments and composite measures of self-care (r values = 0.31, 0.29). Moderation analyses suggest that effects for most other types of self-care are also near the medium range, especially in studies with stronger methodologies. CONCLUSIONS—These findings demonstrate a significant association between depression and treatment nonadherence in patients with diabetes. Studies that used stronger methodologies had larger effects. Treatment nonadherence may represent an important pathway between depression and worse diabetes clinical outcomes. American Diabetes Association 2008-12 /pmc/articles/PMC2584202/ /pubmed/19033420 http://dx.doi.org/10.2337/dc08-1341 Text en Copyright © 2008, American Diabetes Association https://creativecommons.org/licenses/by-nc-nd/3.0/Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details. |
spellingShingle | Reviews/Commentaries/ADA Statements Gonzalez, Jeffrey S. Peyrot, Mark McCarl, Lauren A. Collins, Erin Marie Serpa, Luis Mimiaga, Matthew J. Safren, Steven A. Depression and Diabetes Treatment Nonadherence: A Meta-Analysis |
title | Depression and Diabetes Treatment Nonadherence: A Meta-Analysis
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title_full | Depression and Diabetes Treatment Nonadherence: A Meta-Analysis
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title_fullStr | Depression and Diabetes Treatment Nonadherence: A Meta-Analysis
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title_full_unstemmed | Depression and Diabetes Treatment Nonadherence: A Meta-Analysis
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title_short | Depression and Diabetes Treatment Nonadherence: A Meta-Analysis
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title_sort | depression and diabetes treatment nonadherence: a meta-analysis |
topic | Reviews/Commentaries/ADA Statements |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2584202/ https://www.ncbi.nlm.nih.gov/pubmed/19033420 http://dx.doi.org/10.2337/dc08-1341 |
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