Depression and Diabetes Treatment Nonadherence: A Meta-Analysis
By Jeffrey S. Gonzalez, M. Peyrot, Lauren McCarl, E. Collins, L. Serpa, M. Mimiaga, S. Safren. Diabetes Care, 2008
1,058 citations recorded by the source corpus.
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.
Subfields: Endocrinology, Diabetes and Metabolism, Epidemiology
View Paper: https://www.semanticscholar.org/paper/b8fb596e27d9df5134d00819c6f2e6d3c1f29a13
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In Endocrinology, Diabetes and Metabolism
In Epidemiology
Citations in the corpus
- Depression and HIV/AIDS Treatment Nonadherence: A Review and Meta-analysis (2011, methodology): “21) obtained by a recent meta-analysis examining the relationship between depression and diabetes treatment adherence.(47) Moderation analyses focused on HAART adherence assessment methods demonstrated a significantly stronger effect (r = 0.”
- Determinants of patient adherence: a review of systematic reviews (2013, background): “Depression was significantly associated with non-adherence across various conditions (OR 3.03, 95%CI 1.96–4.89) (DiMatteo et al., 2000), and in particular, in diabetes (z 9.97, P 0.0001) (Gonzalez et al., 2008).”
- Diabetes Distress but Not Clinical Depression or Depressive Symptoms Is Associated With Glycemic Control in Both Cross-Sectional and Longitudinal Analyses (2009, background): “For example, for some patients, high disease distress can influence self-management and medication adherence with subsequent effects on glycemic control, and for other patients, poor control can lead to distress, which can influence disease management (23).”