Baseline depression independently predicted non-adherence to a cardiac rehabilitation program in patients with cardiovascular disease (OR 1.14).
Cohort (n=3,659)
No
Does baseline depression or anxiety predict non-adherence to cardiac rehabilitation programs in patients with cardiovascular disease?
Baseline depression is an independent predictor of non-adherence to cardiac rehabilitation in Latin American patients, highlighting the need for routine psychological screening at program entry.
Estimación del efecto: OR 1.14 (95% CI 1.00-1.31)
Background: Cardiovascular diseases (CVD) are the leading cause of mortality worldwide, and the primary cause of death from noncommunicable diseases in Colombia.Cardiac rehabilitation programs (CRPs) are effective strategies to reduce cardiovascular mortality, improve functional capacity and healthcare costs.However, their success depends on patient adherence, which remains suboptimal, particularly in low-and middle-income countries (LMICs) where CRPs are underutilized and understudied.The prognostic impact of anxiety and depression on adherence remains largely unexplored in LMICs, where socioeconomic, cultural, and healthcare access barriers may amplify their impact.Methods: We conducted a retrospective cohort study including patients 18 years who entered CRP, at a Colombian teaching hospital, between 2004 and 2014.Baseline anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS).Adherence was defined as attending 30 of 36 sessions.Nested logistic regression models examined the prognostic association between anxiety, depression, and non-adherence, adjusting for demographic and clinical variables.Results: Among 3,659 patients (median age 62 years; 66.2% male).Overall, non-adherence reached 51.1%.Anxiety was present in 27.9% of patients and depression in 16.5%.Depression independently predicted non-adherence (OR 1.14; 95% CI: 1.00-1.31),after adjustment for confounders.Anxiety lost statistical significance in adjusted models (OR 1.06; 95% CI: 0.95-1.19).Conclusions: Depression at program entry is a modifiable independent predictor of nonadherence in a Latin American CRP.Routine psychological screening and early management J o u r n a l P r e -p r o o f 4 of depressive symptoms could enhance adherence and optimize CRPs' effectiveness in resource-limited settings.
Rincón-Hoyos et al. (Sun,) conducted a cohort in Cardiovascular disease (n=3,659). Baseline depression (HADS-D ≥8) vs. No baseline depression was evaluated on Non-adherence to cardiac rehabilitation (attending <30 of 36 sessions) (OR 1.14, 95% CI 1.00-1.31). Baseline depression independently predicted non-adherence to a cardiac rehabilitation program in patients with cardiovascular disease (OR 1.14).