ArticleJournal of managed care & specialty pharmacy2026
Association between comorbid depression, antidepressant adherence, and disease-modifying therapy adherence among Texas Medicaid patients with sickle cell disease.
Article in Journal of managed care & specialty pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Factors associated with longitudinal hydroxyurea adherence trajectories among individuals with sickle cell disease in Texas Medicaid: A group-based trajectory modeling study.Therapeutic advances in hematology · 2026Article
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4 authors.
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Abstract
backgroundDepression is a common mental health comorbidity among patients with sickle cell disease (SCD) and is associated with increased health care utilization, increased costs, and poorer quality of life. Although depression and antidepressant adherence have been shown to be associated with medication adherence in other chronic conditions, research examining these associations in SCD is lacking.
objectiveTo determine whether comorbid depression and antidepressant medication adherence are associated with adherence to SCD disease-modifying therapies (DMTs) among Texas Medicaid patients with SCD.
methodsThis retrospective study analyzed Texas Medicaid claims data (01/2016 to 08/2023) for individuals who had at least 3 medical claims for SCD, had at least 1 prescription claim for an SCD DMT, were aged 8 to 63 years, and were continuously enrolled for 6 months before and 12 months after the index date (first claim for an SCD DMT). In addition to the above, patients with depression had at least 1 medical claim for a depressive disorder, and those with treatment had at least 1 prescription claim for a selective serotonin reuptake inhibitor or serotonin-norepinephrine reuptake inhibitor. Adherence was measured using proportion of days covered (PDC). Descriptive and inferential statistics were used to describe and compare demographic and clinical characteristics and medication adherence between patients with SCD with or without comorbid depression. Multivariable logistic regression was used to determine the association between comorbid depression, antidepressant adherence, and SCD DMT adherence.
resultsAmong 1,005 patients with SCD (22.9 ± 11.7 years), 35.3% had comorbid depression. Mean PDC for each SCD DMT was 38.7 ± 26.7% (hydroxyurea), 37.5 ± 29.5% (L-glutamine), 33.9 ± 30.4% (crizanlizumab), and 60.9 ± 34.1% (voxelotor). Overall SCD DMT adherence was 11.7% (PDC ≥ 80%) and 17.2% (PDC ≥ 70%), and significantly lower among patients with comorbid depression compared with those without comorbid depression (7.6% vs 14.0%;
conclusionsMore than one-third of patients with SCD had depression, and depression was associated with lower SCD DMT adherence. Antidepressant-adherent patients had higher odds of being adherent to SCD DMTs. Providers should regularly screen for depression and initiate and encourage antidepressant adherence, as this may potentially improve adherence to SCD DMTs. Given the known association between medication adherence and health outcomes, improving adherence to SCD DMTs may improve the health outcomes in this population.
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