Yaşlılarda Depresyon ile Antihipertansif İlaç Uyumu İlişkisi

Abstract

Amaç: Araştırma hipertansiyonu olan yaşlı hastalarda depresyon varlığının belirlenmesi ve tedaviye uyumu ile ilişkisinin değerlendirilmesi amacıyla yapılmıştır. Gereç ve Yöntemler: Tanımlayıcı ve korelasyonel nitelikte olan araştırmanın örneklemini antihipertansif ilaç kullanan 65 yaş ve üzeri 334 hasta oluşturmuştur. Veriler, antihipertansif ilaç tedavisine uyum ölçeği ve geriatrik depresyon ölçeği kullanılarak toplanmıştır. Bulgular: Araştırmaya katılan hastaların %58,4’ü antihipertansif ilaç tedavisine uyum ölçeğinden aldıkları puana göre uyumsuz olarak değerlendirilmiştir. Hastaların uyum ölçeğinden aldıkları puan ortalaması 7,29 ± 2,65 olarak bulunmuştur. Araştırma kapsamına alınan hastaların %39,5’inin depresyon ölçeğinden aldıkları puan ortalamasına göre hafif derecede depresyonda olduğu bulunmuştur. Depresyon ölçeğinden alınan puan ortalaması 6,70 ± 3,44 olarak bulunmuştur. Araştırmaya katılan hastaların yaşı arttıkça antihipertansif ilaç tedavisine uyum ölçeğinden aldıkları puanın arttığı, aralarında zayıf düzeyde pozitif yönde anlamlı bir ilişki olduğu bulunmuştur (r=0,113, p=0,038). Sonuç: Sonuç olarak yaşlılarda tedaviye uyum ile depresyon düzeyleri arasında ilişki bulunmaktadır. Yaşlı hastaların yaşı arttıkça tedaviye uyum düzeyleri azalmakta ve depresif belirtileri artmaktadır. Bu nedenle sağlık profesyonellerinin hipertansiyon gibi kronik hastalığı olan yaşlılarda depresyon belirtilerini rutin olarak değerlendirmesi gerekmektedir.

Keywords

• Depresyon
• hipertansiyon
• ilaç uyumu
• yaşlı

Relationship between Depression and Antihypertensive Medication Adherence in the Elderly

Abstract

Aim: This study was conducted to determine the presence of depression in elderly patients with hypertension and to evaluate its relationship with treatment adherence. Material and Methods: The sample of this descriptive and correlational study consisted of 334 patients with aged 65 and over which using antihypertensive drugs. Data were collected using the hypertension compliance assessment scale and the geriatric depression scale. Results: 58.4% of the patients participating in the study were evaluated as incompatible according to the score they got from the hypertension compliance assessment scale. The mean score that the patients got from the compliance scale was found as 7.29 ± 2.65. 39.5% of the patients included in the study were found to be mildly depressed compared to the average score they got from the depression scale. The mean score obtained from the depression scale was found to be 6.70 ± 3.44. As the age of the patients participating in the study increased, it was found that the score which they got from the hypertension compliance assessment scale increased, and there was a weakly positive significant relationship between them (r = 0.113, p = 0.038). Conclusion: As a result, there is a relationship between treatment compliance and depression levels in the elderly. As the age of elderly patients increases, their level of compliance with treatment decreases and their depressive symptoms increase. Therefore, healthcare professionals should routinely evaluate the symptoms of depression in the elderly with chronic diseases such as hypertension.

Keywords

• Depression
• hypertension
• medication adherence
• aged

References

1. World Health Organization; World report on Ageing and Health. WHO Library Cataloguing-in-Publication Data..World Health Organization. [Updated: 2014 April 1; Cited: 2020 June 20] [Internet]. Available from: http://apps.who.int/iris/bitstream/10665/186463/1/9789240694811_eng.pdf?ua=1.
2. Turkish Statistical Institute. [Updated: 2020 January 10; Cited: 2020 June 10] [Internet]. Available from: http://www.tuik.gov.tr
3. Irmak Z, Türkcan Düzöz G, Bozyer İ. Effect of an education programme on the lifestyle change and compliance to drug therapy of hypertensive patients. Journal of Nursing School. 2007; 39–47.
4. Özdemir Ö, Akyüz A, Doruk H. Compliance with drug treatment in geriatric patients with hypertension. Medical Journal of Bakırköy. 2016; 12: 195-201.
5. Turkish society of hypertension and kidney diseases. [Updated: 2020 February 10; Cited: 2020 September 15] [Internet]. Available from: http://www.turkhipertansiyon.org/prevelans_calismasi_2.php.
6. Aşılar R, Gözüm S. Hypertensive individuals’ use of complementary health approaches and its effect on adherence with antihypertensive medication treatment. Turkish Journal of Family Medicine and Primary Care. 2017; 11: 235-44.
7. Hacıhasanoğlu R. Treatment compliance affecting factors in hypertension. TAF Prev Med Bull. 2009; 8: 167-72.
8. Sertel M, Tarsuslu Şimşek T, Yümin ET. An analysis of the relationship between cognitive status, depression level and balance in the elderly. Journal of Exercise Therapy and Rehabilitation. 2016; 3: 90-5.

9. Morisky DE, Ang A, Krousel M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich). 2008; 10: 348-54.
10. Demirezen E. Antihypertensive medication compliance in hypertensive Turkish patients living in Turkey and Germany [Doctorate Thesis]. İstanbul: İstanbul University Institute of Health Sciences, Department of Public Health Nursing; 2006.
11. Mert H, Ozcakar N, Kuruoğlu EA. Multidisciplinary special study module research: treatment compliance of patients with hypertension. Turkish Journal of Family Medicine. 2011; 15: 7-12.
12. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982; 17: 37-49.
13. Aktürk Z, Şahin EM, Dağdeviren N, Özer C. The internal reliability analysis of the geriatric depression scale localized into Turkish. In: V. National Congress of Family Medicine; Congress Programme and Book; 2002. p.442.
14. Turhan Ö, Kibar E, Ekren E, Engin O, Ercan D, Erdal AI, et al. Medication adherence in elderly: A university hospital-based and descriptive study. Nobel Medicus. 2014; 10: 2-10.
15. Abreu DP, Santos SC, Silva BT, Gomes GC, Cruz VD, Tier CG. Prevalence of medication therapy adherence in the elderly and related factors. Rev Bras Enferm. 2016; 69: 313-20.
16. Filho AD, Barreto JA, Neves SJ, Lyra DP. Association between the 8-item Morisky Medication Adherence Scale (MMAS-8) and blood pressure control. Arq Bras Cardiol. 2012; 99: 649-58.
17. Lee U, Ku S, Noh G, Baek S, Choi B, Mashour GA. Disruption of frontal-parietal communication by ketamine, propofol, and sevoflurane. Anesthesiology. 2013;118:1264-75.
18. Frances Yap A, Thirumoorthy T, Heng Kwan Y. Medication adherence in the elderly. Journal of Clinical Gerontology and Geriatrics. 2016; 7(2): 64-7.
19. Atan G, Karabulutlu EY. Investigation of lifestyle, life quality and treatment compliance of the patients with essential hypertension. Journal of Nursing Sciences. 2016; 8: 17-25.
20. Tel H, Tay BN, Canbay M, Akaya İ. Disability and depression among the elderly people with chronic physical disease. Florence Nightingale Nursing Journal. 2014; 22: 69-75.
21. Kahraman C. The effect of malnutrition on cognitive functions,depression and quality of life in patients with geriatric hospitalized. [Master disseratation]. İstanbul: Fatih Sultan Mehmet Education and Research Hospital; 2009.
22. Cheung BM, Au THY, Chan SY, Lam CM, Lau SH, Lee RP. The relationship between hypertension and anxiety or depression in Hong Kong Chinese. Exp Clin Cardiol. 2005; 10(1): 21-4.
23. Yılmaz E. A study on the burnout levels of nursing home staff. International Journal of Social Sciences. 2017; 9: 1-21.
24. Li ZY, Li Y, Chen L, Chen P, Hu Y. Prevalence of depression in patients with hypertension: A systematic review and meta-analysis. Medicine (Baltimore). 2015; 94(31): 1-6.