Role of Depression and Medication

Medication adherence is delineated as the magnitude to which patients take medications as recommended by their health-care providers. Correct and accurate adherence to a treatment plan, particularly taking medication on a regular basis and as recommended in the prescriptions is a shared clinical challenge not only for clinicians but patients as well. The population growth of older adults continues to magnify and increase with the baby boomer age group almost coming to their age of retiring.

The inference of this is that there is an increasing necessity for enhancing healthcare results amongst patients suffering from heart failure. Self-care discrepancies have been established to be considerably linked with deleterious healthcare results amongst heart failure patients. It has been conveyed that patients with heart failure who show diminished self-care capabilities in undertakings like medication compliance have recurrent hospitalizations and dwindled quality of life (Britz and Dunn, 2010).

Medication adherence is a multi-faceted aspect impacted by different areas including factors associated to a certain condition, for instance, the severity of the signs and comorbidity. In this regard, depression has been demonstrated to be a fundamental factor in medication adherence. This is a progressively more worrying issue in patients with heart failure as the rate of nonadherence to treatment plans ranged between 40 and 60 percent.

Research has indicated that signs of major depressive syndromes like lassitude, lack of motivation, incapability to focus, social withdrawal, and sentiments of being insignificant or irrelevant deter peoples’ abilities to stick to the treatment plan (Tang et al., 2014). There is comprehensive current knowledge on the role of depression on adherence to treatment among heart failure patients. However, Tang et al. (2014) indicate that a great deal of literature in this topic takes into account the dynamic that exists between depression and medication adherence in the area of chronic illnesses.

On the basis of 31 research studies that spun more than 18,000 participants, majority of the meta-analysis established that individuals experiencing depression had a greater likelihood of approximately 1.76 to 3.03 times of being non-adherent to the treatment plan in comparison to individuals who were not depressed. Moreover, knowledge in the area shows that enhancement in the depression rankings or scores had a positive correlation with self-reported medication adherence. These high and alarming rates of unsuitable medication adherence in the individuals experiencing depression bring into light the need for intervention in these patients.

Imperatively, Tang et al. (2014) reports that there are some inconsistencies in the literature with respect to the topic. This is the sense that a number of studies have provided depression in a dissimilar manner as well as the measurement of medication adherence. That is, whether the measurements were through records from the pharmacy, self-report, or electronic systems for monitoring medication.

In addition, a number of studies demonstrated that individuals who were highly or incessantly depressed had a tendency to over-report their treatment non-adherence in comparison to the individuals who were not experiencing depression or those in remission. Heart failure is considered to be one of the most prevalent cardiovascular ailments internationally with reported figures of more than 6 million people in the United States and 23 million people across the globe. It is a disorder that necessitates life-long adherence to an intricate medication course of therapy or schedule.

Mental symptoms like depression are common in the disorder. In particular, there have been reports of depression being as high as 25 percent in outpatient HF patients and 70 percent in inpatient ones, with these significant rates having an impact on the adherence of the medication plan and the health of the patient at large. In addition, there are studies that have employed objective and subjective measurements to assess the role of depression on medication adherence amongst the individuals suffering from HF.

Outcomes have indicated that depression was an indicator for the subjective measure and not the objective measure (Tang et al., 2014). The literature reviewed is largely adequate and has sufficient quality. Nonetheless, there are prevailing knowledge gaps. The knowledge gap that presently exists is the lack of research able to determine the manner in which nurse practitioners (NPs) can detect and ascertain hospitalized heart failure patients who are at risk for poor quality of life outcomes on the basis of their prevailing self-care insufficiencies.

There is lack of knowledge in understanding the manner in which NPs can go on providing, overall, uniform interventions, and discharge guidelines to patients suffering from heart failure when they have lacked the ability to ascertain.