Collaborative care for comorbid depression and coronary heart disease: a systematic review and meta-analysis of randomised controlled trials
Open accessAbstract
Objectives: To systematically review the efficacy of collaborative care (CC) for depression in adults with coronary heart disease (CHD) and depression. Design: Systematic review and meta-analysis. Data sources: Electronic databases (Cochrane Central Register of Controlled Trials MEDLINE, EMBASE, PsycINFO and CINAHL) were searched until April 2014. Inclusion criteria: Population, depression comorbid with CHD; intervention, randomised controlled trial (RCT) of CC; comparison, either usual care, wait-list control group or no further treatment; and outcome, (primary) major adverse cardiac events (MACE), (secondary) standardised measure of depression, anxiety, quality of life (QOL) and cost-effectiveness. Data extraction and analysis: RevMan V.5.3 was used to synthesise the data as risk ratios (RRs), ORs and standardised mean differences (SMD) with 95% CIs in random effect models. Results: Six RCTs met the inclusion criteria and comprised 655 participants randomised to CC and 629 participants randomised to the control group (total 1284). Collaborative depression care led to a significant reduction in MACE in the short term (three trials, RR 0.54; 95% CI 0.31 to 0.95, p=0.03) that was not sustained in the longer term. Small reductions in depressive symptoms were evident in the short term (6 trials, pooled SMD −0.31; 95% CI −0.43 to −0.19, p<0.00001) and depression remission was more likely to be achieved with CC (5 trials, OR 1.77; 95% CI 1.28 to 2.44, p=0.0005). Likewise, a significant effect was observed for anxiety symptoms (SMD −0.36) and mental QOL (SMD 0.24). The timing of the intervention was a source of between-group heterogeneity for depression symptoms (between groups p=0.04, I 2 =76.5%). Conclusions: Collaborative depression care did not lead to a sustained reduction in the primary MACE end point. Small effects were observed for depression, depression remission, anxiety and mental QOL. Trials registration number: PROSPERO CRD42014013653.
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Collaborative care interventions have shown positive effects for people with depressive symptoms and coronary heart disease, breast cancer, and diabetes mellitus.
“Collaborative care interventions have shown positive effects for people with depressive symptoms and coronary heart disease366, breast cancer367, and diabetes mellitus292,364.”
From Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management (2023) · cites this paper as [366]
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- Authors
- Tully, P. J., & Baumeister, H.
- Affiliations
- Inserm (FR)
- University of Freiburg (DE)
- Corresponding author
- Baumeister, Harald
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2015-12
- Volume
- 5
- Issue
- 12
- Pages
- e009128
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4691772
- OpenAlex
- W2209406286
- Cited by
- 120
- References
- 56
- Citations by year
- 2026: 7 · 2025: 6 · 2024: 11 · 2023: 16 · 2022: 13 · 2021: 12 · 2020: 13 · 2019: 9 · 2018: 13 · 2017: 13 · 2016: 6 · 2015: 1
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- RUNE (Research UNE) (submittedVersion, cc-by-nc)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion, cc-by-nc)
- Figshare (submittedVersion, cc-by-nc)
- FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
- Funders
- Deutsche Forschungsgemeinschaft
- Medical Research Council
- National Health and Medical Research Council (1053578)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- collaborative care, depression, coronary artery disease, comorbidities, major adverse cardiac events, depression remission, anxiety, quality of life, cost-effectiveness, primary care, cardiac rehabilitation, intervention timing, sustained treatment effects
- MeSH terms
- Anxiety, Cooperative Behavior, Coronary Artery Disease, Depression, Humans, Patient Care Team, Psychotherapy, Quality of Life, Comorbidity, Randomized Controlled Trials as Topic, Publication Bias, Case Management
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