Predictors of adherence to exercise interventions in patients with clinical depression – A pooled analysis from two clinical trials

• Higher age and satisfaction with intervention is associated with high attendance.
• Severity of depression or anxiety does not predict attendance.
• Motivational focus on younger participants should be encouraged.

BackgroundPhysical activity is inversely associated with the risk of cardiovascular disease, diabetes and all-cause mortality. Patients with depression are less likely to be physically active, and thus more prone to developing these diseases. The aim of this study was to identify patient and study characteristics associated with adherence to exercise interventions.MethodWe pooled data from patients allocated to active exercise interventions from two previously conducted exercise trials (n = 166) offering two or three weekly sessions. We divided the patients into a high attendance or a low attendance group. We then compared patient characteristics, distance to training facilities, depression, anxiety, and satisfaction with the offered intervention between the two groups.ResultsHigh attendance was positively associated with age (p = 0.05) and satisfaction with the intervention (p < 0.001). We found no association between attendance and any other patient characteristics, severity of depression, severity of anxiety, or distance to training facilities. Patient satisfaction was positively associated with the patient's age (p = 0.008) and improvement in depression (p = 0.04). Median attendance did not differ between the two trials offering two or three sessions per week (p = 0.44).ConclusionSeverity of depression or anxiety in mild to moderate depression did not predict attendance, but high attendance was associated with higher age and satisfaction with the intervention. These findings suggest that motivational focus on younger participants should be encouraged and ways to improve satisfaction with the intervention should be considered.