Association Between Depressive Symptom Severity and Treatment Adherence Among Primary Care Patients with Hypertension in Taizhou, East China: A Multicenter Cross-Sectional Study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Depressive symptoms are common among adults with hypertension and may interfere with the medication-taking and lifestyle behaviours required for long-term treatment. Evidence from Chinese primary care is limited, and most previous studies assessed medication-taking alone rather than overall treatment adherence. Methods: In this multicenter cross-sectional study conducted from January to December 2023, 2892 adults with physician-diagnosed hypertension were included from 12 primary health-care centres in Taizhou, Zhejiang Province, East China. Depressive symptoms were measured using the 9-item Patient Health Questionnaire (PHQ-9), and treatment adherence was measured using the Hypertension Treatment Adherence Scale (TASHP). Sequentially adjusted logistic regression was used to estimate associations, and restricted cubic splines described the dose-response relationship. Results: Of the 2892 participants (mean age 70.9 ± 10.4 years; 54.6% women), 1304 (45.1%) reported poor treatment adherence and 643 (22.2%) had PHQ-9 scores ≥5. In the fully adjusted model, a PHQ-9 score of ≥5 was associated with higher odds of poor adherence than a PHQ-9 score of 0-4 (adjusted odds ratio [aOR] 1.93, 95% confidence interval [CI] 1.59-2.33, P < 0.001). In a model with a linear term, each 1-point increase in PHQ-9 score was associated with a 12% increase in odds (aOR 1.12, 95% CI 1.09-1.16). Compared with scores of 0-4, the aOR was 1.89 (95% CI 1.56-2.30) for scores of 5-9 and 2.61 (95% CI 1.31-5.20) for scores of ≥10; the dose-response relationship was non-linear (P for non-linearity < 0.001). Conclusion: Greater depressive symptom severity was associated with poorer self-reported treatment adherence among Chinese primary care patients. Prospective and interventional studies are warranted before depression screening or integrated care can be recommended to improve adherence.
Source: Patient Preference and Adherence
DOI: 10.2147/ppa.s642856
Language: English
Subfield: Family Practice
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
OpenAlex ID: W7224872715