Psychological factors in end-stage renal disease: An emerging context for behavioral medicine research.

Christensen, Alan J.; Ehlers, Shawna L.

doi:10.1037/0022-006x.70.3.712

Cited by 177 publications

(138 citation statements)

References 115 publications

(150 reference statements)

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“…The fi rst is that we used MEMS caps to measure adherence. All methods for assessing adherence have limitations: selfreports may be insensitive, 32 drug levels may be infl uenced by factors other than treatment adherence, 33 pill counts are subject erratic patient behaviors, 34 verifi cation of pharmacy records may be useful only for extended time frames, 35 and MEMS caps may be expensive and opening pill bottles is assumed to be synonymous with medication ingestion. 36 We chose to use MEMS caps as our primary measure of adherence because MEMS caps have a low failure rate 31 and may be more sensitive than other adherence measures.…”

Section: Discussionmentioning

confidence: 99%

Integration of Depression and Hypertension Treatment: A Pilot, Randomized Controlled Trial

Bogner¹,

Vries²

2008

The Annals of Family Medicine

120

122

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PURPOSE We wanted to examine whether integrating depression treatment into care for hypertension improved adherence to antidepressant and antihypertensive medications, depression outcomes, and blood pressure control among older primary care patients. METHODSOlder adults prescribed pharmacotherapy for depression and hypertension from physicians at a large primary care practice in West Philadelphia were randomly assigned to an integrated care intervention or usual care. Outcomes were assessed at baseline, 2, 4, and 6 weeks using the Center for Epidemiologic Studies Depression Scale (CES-D) to assess depression, an electronic monitor to measure blood pressure, and the Medication Event Monitoring System to assess adherence. RESULTSIn all, 64 participants aged 50 to 80 years participated. Participants in the integrated care intervention had fewer depressive symptoms (CES-D mean scores, intervention 9.9 vs usual care 19.3; P <.01), lower systolic blood pressure (intervention 127.3 mm Hg vs usual care 141.3 mm Hg; P <.01), and lower diastolic blood pressure (intervention 75.8 mm Hg vs usual care 85.0 mm Hg; P <.01) compared with participants in the usual care group at 6 weeks. Compared with the usual care group, the proportion of participants in the intervention group who had 80% or greater adherence to an antidepressant medication (intervention 71.9% vs usual care 31.3%; P <.01) and to an antihypertensive medication (intervention 78.1% vs usual care 31.3%; P <.001) was greater at 6 weeks.CONCLUSION A pilot, randomized controlled trial integrating depression and hypertension treatment was successful in improving patient outcomes. Integrated interventions may be more feasible and effective in real-world practices, where there are competing demands for limited resources. Ann Fam Med 2008;6:295-301. DOI: 10.1370/afm.843. INTRODUCTIONP rimary care occupies a strategic position in the evaluation and treatment of depression among older adults, 1 and enhancing depression management in primary care appears to be a promising use of health care resources.2 To have an impact on public health, advances in the treatment of depression must be realized in primary care. Although recent studies have shown that a variety of primary care interventions can improve depression outcomes among older adults, 3,4 these interventions are not being widely implemented in practice. Some evidence indicates that addressing medical comorbidity, especially cardiovascular disease (CVD), may be essential in managing depression. [5][6][7] In addition, managing depression in the context of medical comorbidity may be more acceptable to patients than managing depression alone. DEPR ES SION A ND HY PER T ENSION T R E AT MEN Tmanagement of depression with management of medical comorbidity.In this trial, we focused on integrating depression management into care for hypertension. Hypertension affects between 20% to 50% of adults in most countries 9 and is a major risk factor for cardiovascular morbidity and mortality, 10 representing two-thirds of all s...

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Section: Discussionmentioning

confidence: 99%

Integration of Depression and Hypertension Treatment: A Pilot, Randomized Controlled Trial

Bogner¹,

Vries²

2008

The Annals of Family Medicine

120

122

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“…Because ESRD is a lifelong disease, feelings of lack of control and perceptions of overwhelming illness might be inevitable. The intrusiveness of these thoughts is related to depression (Christensen & Ehlers, 2002;Devins et al, 1997).…”

Section: Psychological and Social Factors For Depressionmentioning

confidence: 99%

The Psychological Impact of Hemodialysis on Patients with Chronic Renal Failure

Wang¹,

Chen²

2012

Renal Failure - The Facts

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“…En la dimensión psicológica algunas de las problemáticas más comunes que afectan la calidad de vida relacionada con la salud en el paciente con ERC son la depresión, la ansiedad y la incertidumbre acerca del futuro (46)(47)(48) .…”

Section: Discussionunclassified

Influencia de la consulta de enfermería de enfermedad renal crónica avanzada en pacientes que inician tratamiento renal sustitutivo

Rubio¹,

Asensio²,

Raventos

2014

Enferm Nefrol

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ResumenLa remisión precoz del paciente con enfermedad renal crónica avanzada al especialista y una atención nefrológica integrada y especializada en la etapa prediálisis, proporcionada por un equipo multidisciplinar, ha demostrado tener importantes beneficios sobre pacientes en fase avanzada de la enfermedad renal que inician tratamiento renal sustitutivo. Objetivo: determinar si existe riesgo de alteraciones a nivel físico, psicológico o de la calidad de vida en pacientes que inician terapia sustitutiva renal en función de si han tenido seguimiento nefrológico multidisciplinar en la etapa prediálisis. Material y métodos: estudio observacional trasversal analítico sobre una muestra de 90 pacientes que inician terapia sustitutiva renal. Resultados: El 86,5% de los pacientes estudiados fue seguido por el nefrólogo en la etapa prediálisis, solo el 37,8% de los pacientes fue atendido por la enfermera. El 27,8% de los pacientes mostraban elevados niveles de ansiedad al iniciar diálisis. No se encontraron diferencias en la calidad de vida relacionado con la salud entre pacientes seguidos o no por la enfermera en la etapa prediálisis. Conclusiones: Un porcentaje muy bajo de pacientes son seguidos en la consulta de enfermería prediálisis, no existiendo diferencias significativas en la calidad de vida relacionada con la salud entre ambos grupos. Si se encontraron diferencias significativas en cuanto a la ansiedad; el grupo de pacientes atendidos por la enfermera en la etapa prediálisis presentan mayores niveles de ansiedad que los no atendidos. No differences in quality of life associated with health among patients followed or not by the nurse in the predialysis phase were found. Conclusions: A very small percentage of patients are followed in predialysis nurses, with no significant differences in quality of life related to health between the two groups. If significant differences were found with regard to anxiety; the group of patients seen by the nurse in the predialysis stage have higher levels of anxiety that unattended. PALABRAS CLAVE KEYWORDS -ERCA -NURSING CONSULTATION -QUALITY OF LIFE -ANXIETY / DEPRESSION ORIGINAL IntroducciónLa enfermedad renal crónica (ERC) presenta para nuestra sociedad actual un grave problema de salud pública, tanto por su elevada incidencia y prevalencia

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Psychological factors in end-stage renal disease: An emerging context for behavioral medicine research.

Cited by 177 publications

References 115 publications

Integration of Depression and Hypertension Treatment: A Pilot, Randomized Controlled Trial

Integration of Depression and Hypertension Treatment: A Pilot, Randomized Controlled Trial

The Psychological Impact of Hemodialysis on Patients with Chronic Renal Failure

Influencia de la consulta de enfermería de enfermedad renal crónica avanzada en pacientes que inician tratamiento renal sustitutivo

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