Linkages between anxiety and outcomes in heart failure
Journal article
De Jong, Marla J., Chung, Misook L., Wu, Jia-Rong, Riegel, Barbara, Rayens, Mary Kay and Moser, Debra K.. (2011). Linkages between anxiety and outcomes in heart failure. Heart and Lung. 40(5), pp. 393 - 404. https://doi.org/10.1016/j.hrtlng.2011.02.002
Authors | De Jong, Marla J., Chung, Misook L., Wu, Jia-Rong, Riegel, Barbara, Rayens, Mary Kay and Moser, Debra K. |
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Abstract | Objective: We investigated the relationship between anxiety and event-free survival ( ie, composite endpoint of death, emergency department visits, or hospitalizations ) for patients with heart failure ( HF ), and examined whether behavioral and physiologic mechanisms mediate any association between anxiety and outcomes. Methods: In this longitudinal study, patients with HF completed the anxiety subscale of the Brief Symptom Inventory, and heart-rate variability and plasma norepinephrine levels were measured. Dietary adherence and medication adherence were measured according to 24-hour urine sodium level and the Medication Event Monitoring System, respectively. Patients were followed at least 1 year for event-free survival. Results: In total, 147 patients were enrolled. Patients with high anxiety had a shorter ( hazard ratio, 2.2; 95% confidence interval, 1.1-4.3; P = .03 ) period of event-free survival than patients with lower anxiety. Anxiety independently predicted adherence to medication ( P = .008 ), which in turn predicted event-free survival ( hazard ratio, 2.0; 95% confidence interval, 1.2-3.3; P = .008 ). The effect of anxiety ( P = .17 ) on event-free survival was less significant when the regression model included both anxiety and adherence to medication than when the model only included anxiety ( P = .03 ), indicating that adherence to medication mediated the relationship between anxiety and event-free survival. Conclusion: This is the first study to show that nonadherence to medication links anxiety and event-free survival for patients with HF. Interventions that reduce anxiety and improve adherence may benefit outcomes. |
Keywords | heart failure; anxiety; adherence; event-free survival |
Year | 2011 |
Journal | Heart and Lung |
Journal citation | 40 (5), pp. 393 - 404 |
Publisher | Mosby Inc. |
ISSN | 0147-9563 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.hrtlng.2011.02.002 |
Scopus EID | 2-s2.0-80052270788 |
Page range | 393 - 404 |
Research Group | Mary MacKillop Institute for Health Research |
Publisher's version | File Access Level Controlled |
Place of publication | United States |
https://acuresearchbank.acu.edu.au/item/87yq5/linkages-between-anxiety-and-outcomes-in-heart-failure
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