Cardiovascular disease (CVD) patients may be commonly diagnosed with depression. The health world recently stumbled upon an enthralling means to improve depression, anxiety and emotional quality of life among such people. With a highly innovation approach, experts have now designed collaborative care programs that display better outcomes in depression, anxiety and emotional quality of life after 6 and 12 weeks among heart disease patients.
In order to determine the efficacy of the collaborative care depression management programs, scientists randomized 175 depressed heart patients mostly Caucasian and about half women. Participants were either subjected to usual care that included a recommendation for depressive treatment or collaborative care. Under collaborative care, patients were provided with written and verbal education about depression as well as its impact on cardiac disease, scheduling pleasurable leisure activities post-discharge, receiving detailed treatment options (medicines or counseling referral), and coordinating follow-up care after discharge.
“Collaborative care depression-management programs have been used in the outpatient setting, but such a program had never been initiated in the hospital or used for patients with a wide range of cardiac illnesses,” added Jeff C. Huffman, M.D., lead author of the study, assistant professor of psychiatry at Harvard Medical School and director of the Cardiac Psychiatry Research Program at Massachusetts General Hospital in Boston. “In the real world this program would be applied on cardiac floors and would be much more easily applied to a large group of patients rather than a small subset or single diagnosis. This kind of economy of scale may make it much more feasible from a resource and cost standpoint.”
On completion of six weeks after leaving the hospital, almost twice as many of the collaborative care patients claimed to have fewer depression symptoms than before. 59.7 percent collaborative care patients and 33.7 percent usual care patients reportedly experienced reduction in their depression symptoms. The differences at 12 weeks were supposedly enhanced with a 51.5 percent depression response rate for collaborative care patients and 34.4 percent for patients receiving usual care.
Huffman said. “While improved mental health is a start, a program may require more intensity to see improved medical outcomes, and larger studies will be needed to see results in a more diverse patient population. Patients with heart disease who have depression are more likely to be rehospitalized, have poorer quality of life and are more likely to die from their heart disease than are people without depression. If an efficient program like this one can be used to identify, treat and monitor depression in heart disease patients, this might lead to lower rates of rehospitalization or death in these patients, though this remains to be proven.”
The effects presumably reduced when the intervention ended at 12 weeks and between-group differences lost their statistical significance by the six-month follow-up call. Rehospitalization rates appeared similar in both the groups. But the collaborative care patients’ self-reported significantly fewer and less severe cardiac symptoms along with better adherence to healthy activities like diet and exercise at six months than the usual care group. It can therefore be concluded that the newly crafted program positively affects overall health.
The study is published in Circulation: Cardiovascular Quality and Outcomes, an American Heart Association journal.