Depression and poor adherence to lipid-lowering medications among patients with coronary artery disease.

摘要

In an article published in the Journal of the American Medical Association in 1975, the Coronary Drag Project Research Group [1] reported that "there is no evidence of significant efficacy of clofibrate with regard to total mortality or cause-specific mortality." The study showed that patients treated with the lipid-lowering drug clofibrate had a 20.0% mortality rate at 5 years compared to a 20.9% rate in those given placebo. Five years later in The New England Journal of Medicine, evidence from the same study showed that patients who were "good adherers" to clofibrate (i.e., those who took 80% or more of their prescribed pills) had a significantly lower mortality (15.0%) than those who were "poor adherers" to clofibrate (24.6%) [2]. This observation seemed to provide evidence that clofibrate was valuable in the treatment of heart disease. However, it was only part of the story. Similar findings were noted in those assigned to placebo; those who were "good adherers" to an inactive tablet had a much lower mortality (15.1%) than those who were "poor adherers" (28.3%).