Coronary artery bypass graft (CABG) patients who were screened for depression after surgery and then cared by health care specialists by means of telephone appear to have an improved quality of life and physical function than those who received their doctors’ usual care. Atleast this is what a latest study from the University of Pittsburgh School of Medicine claims.
With more than 450,000 procedures carried out every year, CABG surgery is known to be one of the most commonly performed. Moreover, it seems to be amongst one of the most costly medical procedures in the United States. However the procedure patently benefits several individuals, approximately 20 to 25 percent are believed to suffer from depressive symptoms following CABG surgery.
In addition, people experiencing depressive symptoms appear to have worse clinical outcomes, including poorer quality of life, sustained chest pains and an increased risk of re-hospitalization and death. This study apparently is the foremost trial to analyze the impact of a collaborative care strategy for treating depression following a severe cardiac episode. The intervention was noted to have comprised weekly telephone follow-up by a nurse via an evidence-based treatment protocol for depression.
For the purpose of the study, the authors were believed to have recruited 453 post-CABG patients from seven Pittsburgh-area hospitals from 2004 through 2007. They included 302 depressed patients who appear to have been randomly assigned to either an eight-month course of telephone-delivered collaborative care or to their doctors’ standard care for depression.
During the study, the nurse seems to have teamed up with the patients’ primary care physicians and the study’s clinical management team. Further, the team was comprised of a psychiatrist, psychologist and internist. Supposedly, this study has showed to be effective for treating major depression in primary care settings. However, it may have never before been applied to a population with heart disease.
Lead author of the study, Bruce Rollman, M.D., M.P.H., associate professor of medicine and psychiatry, Center for Research on Health Care, University of Pittsburgh School of Medicine said that, “Dozens of studies have described a link between depression and heart disease, and the most recent science advisory from the American Heart Association recommends screening patients with heart disease for depression. However, few depression treatment trials have involved cardiac patients and none used the collaborative care model or examined the impact of treating post-CABG depression on quality of life, re-hospitalizations or health care costs, as we did.”
Furthermore, the authors at random tested an additional 151 non-depressed, post-CABG patients in order to make possible comparisons to depressed patients. They tracked these patients to examine quality of life, physical performance, mood symptoms, re-hospitalizations, health care costs and deaths.
“Men with depression were particularly likely to benefit from the intervention. However, the mean health-related quality of life and physical functioning of intervention patients did not reach that of the non-depressed comparison group,” explains Dr. Rollman.
The findings of the study revealed that the patients appear to have reported better improvements in mental health- related quality of life, physical functioning and mood symptoms. Overall, nearly 50 percent of them seem to have reported a 50 percent or greater decrease in mood symptoms from baseline to eight-month follow-up against 29.6 percent of patients in normal care.
The findings of the study ‘Bypassing the Blues’ have been published in the Journal of the American Medical Association (JAMA).