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Adherence to Risk Factor Management Instructions after Acute Myocardial Infarction: The Role of Emotional Support and Depressive Symptoms

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Emotional support and depression may influence adherence to risk factor management instructions after acute myocardial infarction (AMI), but their role requires further investigation.

Purpose

To examine the longitudinal association between perceived emotional support and risk factor management adherence and assess depressive symptoms as a moderator of this association.

Methods

Among 2,202 AMI patients, we assessed adherence to risk factor management instructions over the first recovery year. Modified Poisson mixed-effects regression evaluated associations, with adjustment for demographic and clinical factors.

Results

Patients with low baseline support had greater risk of poor adherence over the first year than patients with high baseline support (relative risk [RR] = 1.20, 95% confidence interval [CI] = 1.02–1.43). In stratified analyses, low support remained a significant predictor of poor adherence for non-depressed (RR = 1.41, 95% CI = 1.23–1.61) but not depressed (RR = 1.01, 95% CI = 0.78–1.30) patients (p for interaction < 0.001).

Conclusions

Low emotional support is associated with poor risk factor management adherence after AMI. This relationship is moderated by depression, with a significant relationship observed only among non-depressed patients.

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Acknowledgments

As a doctoral student, Dr. Leifheit-Limson was supported by National Institute on Aging training grant T32AG00153. PREMIER was principally supported by CV Therapeutics, Inc., with funding for all analyses from CV Outcomes, Inc.

Conflict of Interest

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Yale University School of Medicine, New Haven, CT, USA

    Erica C. Leifheit-Limson Ph.D, Stanislav V. Kasl Ph.D, Haiqun Lin MD, Ph.D & Judith H. Lichtman Ph.D, MPH

  2. Saint Luke’s Mid America Heart Institute, Kansas City, MO, USA

    Donna M. Buchanan Ph.D & John A. Spertus MD, MPH

  3. University of Colorado-Denver, Aurora, CO, USA

    Pamela N. Peterson MD, MSPH

  4. Denver Health Medical Center, Denver, CO, USA

    Pamela N. Peterson MD, MSPH

  5. University of Missouri—Kansas City, Kansas City, MO, USA

    John A. Spertus MD, MPH

  6. Department of Epidemiology and Public Health, Yale University School of Medicine, 2 Church Street South, Suite 510, New Haven, CT, 06519, USA

    Erica C. Leifheit-Limson Ph.D

Authors
  1. Erica C. Leifheit-Limson Ph.D
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  2. Stanislav V. Kasl Ph.D
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  3. Haiqun Lin MD, Ph.D
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  4. Donna M. Buchanan Ph.D
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  5. Pamela N. Peterson MD, MSPH
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  6. John A. Spertus MD, MPH
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  7. Judith H. Lichtman Ph.D, MPH
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Corresponding author

Correspondence to Erica C. Leifheit-Limson Ph.D.

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Leifheit-Limson, E.C., Kasl, S.V., Lin, H. et al. Adherence to Risk Factor Management Instructions after Acute Myocardial Infarction: The Role of Emotional Support and Depressive Symptoms. ann. behav. med. 43, 198–207 (2012). https://doi.org/10.1007/s12160-011-9311-z

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  • DOI: https://doi.org/10.1007/s12160-011-9311-z

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