Impact of a Depression Care Management Program for Hospitalized Cardiac Patients
Abstract
Background—: Depression is independently associated with poor outcomes among patients with acute cardiac disease. Collaborative care depression management programs have been used in outpatients to improve depression outcomes, but such a program had never been initiated in the hospital or used for patients with a wide range of cardiac illnesses. Methods and Results—: This was a prospective, randomized trial of a low-intensity, 12-week collaborative care program versus usual care for 175 depressed patients hospitalized for acute coronary syndrome, arrhythmia, or heart failure. Study outcomes, assessed using mixed regression models to compare groups at 6 weeks, 12 weeks, and 6 months, included mental health (depression, cognitive symptoms of depression, anxiety, and mental health-related quality of life) and medical (physical health-related quality of life, adherence to medical recommendations, and cardiac symptoms) outcomes. Collaborative care subjects (n=90) had significantly greater improvements on all mental health outcomes at 6 and 12 weeks, including rates of depression response (collaborative care, 59.7% versus usual care 33.7%; odds ratio, 2.91; P =0.003 at 6 weeks; 51.5% versus 34.4%; odds ratio, 2.02; P =0.04 at 12 weeks), though these effects decreased after intervention. At 6 months, intervention subjects had significantly greater self-reported adherence and significantly reduced number and intensity of cardiac symptoms. Conclusions—: Among patients with a broad range of cardiac diagnoses, a collaborative care depression management program initiated during hospitalization led to significant improvements in multiple clinically important mental health outcomes and had promising effects on relevant medical outcomes after intervention. Clinical Trial Registration—: URL: http://www.clinicaltrials.gov . Unique identifier: NCT00847132.
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The collaborative care trials were not fully powered for major cardiac outcomes, and absolute rates of cardiac events or mortality were highly similar in intervention and control conditions, suggesting that even substantially larger trials may have observed no effect.
“Although these trials were not fully powered for major cardiac outcomes, absolute rates of cardiac events or mortality were highly similar in intervention and control conditions in these studies, suggesting that even substantially larger trials may have observed no effect.”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [187]
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- Authors
- Huffman, J. C., Mastromauro, C. A., Sowden, G., Fricchione, G. L., Healy, B. C., & Januzzi, J. L.
- Affiliations
- Harvard University (US)
- ORCID
- Venue
- Circulation: Cardiovascular Quality and Outcomes
- Published
- 2011-03
- Volume
- 4
- Issue
- 2
- Pages
- 198-205
- ISSN
- 1941-7705 (ISSN-L)
- 1941-7713
- OpenAlex
- W2103872936
- Cited by
- 99
- References
- 35
- Citations by year
- 2025: 3 · 2024: 4 · 2023: 9 · 2022: 5 · 2021: 5 · 2020: 2 · 2019: 8 · 2018: 3 · 2017: 13 · 2016: 5 · 2015: 11 · 2014: 8 · 2013: 10 · 2012: 11
- FWCI
- 6.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation Cardiovascular Quality and Outcomes (publishedVersion)
- PubMed (publishedVersion)
- 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
- depression, collaborative care, care management, hospitalized cardiac patients, acute coronary syndrome, heart failure, cardiac arrhythmias, anxiety, quality of life, medication adherence, cardiac symptoms, low-intensity intervention
- MeSH terms
- Aged, Antidepressive Agents, Arrhythmias, Cardiac, Cardiovascular Agents, Depression, Female, Heart Failure, Humans, Inpatients, Male, Middle Aged, Patient Compliance, Prospective Studies, Quality of Life, Regression Analysis, Single-Blind Method, Treatment Outcome, Acute Coronary Syndrome
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