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Depression, Anxiety, Stress Impact Adherence to Cardiac Rehab

Patients with moderate depression, anxiety, stress symptoms more likely to drop out of rehab

THURSDAY, Oct. 17, 2019 (HealthDay News) — Moderate depression, anxiety, and stress affect adherence to cardiac rehabilitation, according to a study published online Oct. 9 in the European Journal of Preventive Cardiology.

Angela Rao, from the University of Technology Sydney, and colleagues conducted a retrospective cohort study of 5,908 patients entering cardiac rehabilitation programs from 2006 to 2017 to examine the impact of moderate depression and anxiety and stress symptoms on program adherence.

The researchers found that 18, 28, and 13 percent of adults entering cardiac rehabilitation programs had moderate depression, anxiety, and stress symptoms, respectively. Compared with those with normal-mild symptoms, the likelihood of dropping out of cardiac rehabilitation was higher among adults with moderate depression (24 versus 13 percent), anxiety (32 versus 23 percent), or stress symptoms (18 versus 10 percent). The strongest predictors of depression were anxiety and stress (odds ratios, 4.395 and 4.527, respectively). Moderate depression and stress were the strongest predictors of moderate anxiety upon entry into cardiac rehabilitation programs (odds ratios, 3.167 and 5.577, respectively).

“Comprehensive, proactive screening, referral and treatment of moderate depression and anxiety symptoms within cardiac rehabilitation programs is required to decrease the severity and impact of depression and anxiety symptoms and to improve adherence to recommendations for heart disease risk factor management, thereby reducing future cardiovascular risk,” the authors write.

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