Depression Outpatient Cardiology Screening Study
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Depression, Peripheral Vascular Disease, Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 21 - Any |
| Updated: | 4/21/2016 |
| Start Date: | January 2012 |
| End Date: | July 2016 |
Randomized Controlled Trial of Screening for Depression in Cardiac Outpatients
This study compares the effects of depression screening and case management to usual care in
cardiology outpatients with documented evidence of coronary heart disease. Despite strong
evidence that depression is a risk factor for cardiac events, there is insufficient evidence
to support the use of depression screening in cardiac patients.
cardiology outpatients with documented evidence of coronary heart disease. Despite strong
evidence that depression is a risk factor for cardiac events, there is insufficient evidence
to support the use of depression screening in cardiac patients.
Depression and cardiovascular disease are highly comorbid, and depression is a risk factor
for psychosocial morbidity, poor adherence to medical treatment regimens, physical
inactivity, poor physical functioning, and medical morbidity and mortality in cardiac
patients, especially following an acute coronary syndrome (ACS). The American Heart
Association recently recommended that all cardiac patients be screened for depression in
order to improve identification and treatment of this risk factor.
Patients are screened for depression during an outpatient cardiology visit and those that
screen positive will be contacted for enrollment into this study. Patients are then
randomized to receive collaborative care involving the patient, the patient's primary care
physician (PCP), the cardiologist and the nurse case manager, or usual care (the patient is
informed he/she screened positive for depression and is advised to contact their PCP and/or
cardiologist). The PCP and/or cardiologist are free to evaluate, treat and refer that
patient to mental health services as they deem necessary.
Patients in both groups will be monitored for depression severity and duration at 3, 6 and
12 months after enrollment. The course of their depression since enrollment or last
follow-up includes remissions, new onsets, relapses, recurrences, and treatment will be
determined.
for psychosocial morbidity, poor adherence to medical treatment regimens, physical
inactivity, poor physical functioning, and medical morbidity and mortality in cardiac
patients, especially following an acute coronary syndrome (ACS). The American Heart
Association recently recommended that all cardiac patients be screened for depression in
order to improve identification and treatment of this risk factor.
Patients are screened for depression during an outpatient cardiology visit and those that
screen positive will be contacted for enrollment into this study. Patients are then
randomized to receive collaborative care involving the patient, the patient's primary care
physician (PCP), the cardiologist and the nurse case manager, or usual care (the patient is
informed he/she screened positive for depression and is advised to contact their PCP and/or
cardiologist). The PCP and/or cardiologist are free to evaluate, treat and refer that
patient to mental health services as they deem necessary.
Patients in both groups will be monitored for depression severity and duration at 3, 6 and
12 months after enrollment. The course of their depression since enrollment or last
follow-up includes remissions, new onsets, relapses, recurrences, and treatment will be
determined.
Inclusion Criteria:
- recent history of Acute Coronary Syndrome or other cardiac event or documented heart
disease
- score of 10 or higher on the Patient Health Questionnaire
Exclusion Criteria:
- suicidal ideation or behavior
- cognitive impairment or inability to read or speak English
- schizophrenia, bipolar disorder
- active substance abuse or alcoholism
- severe valvular disease, severe congestive heart failure, malignancy
- physical limitations that would interfere with participation in the study
- medical contraindications to the use of available antidepressants
- participation in a competing research protocol
- physician or patient refusal
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