Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In their study of adherence to evidence-based pharmacotherapy and long-term mortality after acute myocardial infarction (AMI), Dr Rasmussen and colleagues1 suggest that the relationship between high adherence and lower mortality is due to an active drug effect rather than to a “healthy adherer” effect. Adherence to placebo has also been associated with lower mortality,2 suggesting that other factors may also be important. One of these factors may be depression, since depression is associated with poor adherence3 and with increased mortality after MI.3
Parakh K, Bush DE, Ziegelstein RC, Thombs BD, Fauerbach JA. Mortality and Adherence to Pharmacotherapy After Acute Myocardial Infarction. JAMA. 2007;297(17):1877–1878. doi:10.1001/jama.297.17.1877-a
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