Open Access
Telephone-Delivered Collaborative Care for Treating Post-CABG Depression
Bruce L. Rollman,Biol Hum,Michelle S. LeMenager,Patricia R. Houck,Peter J. Counihan,Wishwa N. Kapoor,Herbert C. Schulberg,Charles F. Reynolds +7 more
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TLDR
Compared with usual care, telephone-delivered collaborative care for treatment of post-CABG depression resulted in improved HRQL, physical functioning, and mood symptoms at 8-month follow-up.Abstract:
CONTEXT
Depressive symptoms commonly follow coronary artery bypass graft (CABG) surgery and are associated with less positive clinical outcomes.
OBJECTIVE
To test the effectiveness of telephone-delivered collaborative care for post-CABG depression vs usual physician care.
DESIGN, SETTING, AND PARTICIPANTS
Single-blind effectiveness trial at 7 university-based and community hospitals in or near Pittsburgh, Pennsylvania. Participants were 302 post-CABG patients with depression (150, intervention; 152, usual care) and a comparison group of 151 randomly sampled post-CABG patients without depression recruited between March 2004 and September 2007 and observed as outpatients until June 2008.
INTERVENTION
Eight months of telephone-delivered collaborative care provided by nurses working with patients' primary care physicians and supervised by a psychiatrist and primary care physician from this study.
MAIN OUTCOME MEASURES
Mental health-related quality of life (HRQL) measured by the Short Form-36 Mental Component Summary (SF-36 MCS) at 8-month follow-up; secondary outcome measures included assessment of mood symptoms (Hamilton Rating Scale for Depression [HRS-D]), physical HRQL (SF-36 PCS), and functional status (Duke Activity Status Index [DASI]); and hospital readmissions.
RESULTS
The intervention patients reported greater improvements in mental HRQL (all P < or = .02) (SF-36 MCS: Delta, 3.2 points; 95% confidence interval [CI], 0.5-6.0), physical functioning (DASI: Delta, 4.6 points; 95% CI, 1.9-7.3), and mood symptoms (HRS-D: Delta, 3.1 points; 95% CI, 1.3-4.9); and were more likely to report a 50% or greater decline in HRS-D score from baseline (50.0% vs 29.6%; number needed to treat, 4.9 [95% CI, 3.2-10.4]) than usual care patients (P < .001). Men with depression were particularly likely to benefit from the intervention (SF-36 MCS: Delta, 5.7 points; 95% CI, 2.2-9.2; P = .001). However, the mean HRQL and physical functioning of intervention patients did not reach that of the nondepressed comparison group.
CONCLUSION
Compared with usual care, telephone-delivered collaborative care for treatment of post-CABG depression resulted in improved HRQL, physical functioning, and mood symptoms at 8-month follow-up.
TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT00091962.read more
Citations
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AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update A Guideline From the American Heart Association and American College of Cardiology Foundation
Sidney C. Smith,Emelia J. Benjamin,Robert O. Bonow,Lynne T. Braun,Mark A. Creager,Barry A. Franklin,Raymond J. Gibbons,Scott M. Grundy,Loren F. Hiratzka,Daniel W. Jones,Donald M. Lloyd-Jones,Margo Minissian,Lori Mosca,Eric D. Peterson,Ralph L. Sacco,John A. Spertus,James H. Stein,Kathryn A. Taubert +17 more
TL;DR: The development of the present guideline involved a process of partial adaptation of other guideline statements and reports and supplemental literature searches, which confirmed that in patients with atherosclerotic vascular disease, comprehensive risk factor management reduces risk as assessed by a variety of outcomes.
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2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
L. David Hillis,Peter K. Smith,John A. Bittl,Charles R. Bridges,John G. Byrne,Joaquin E. Cigarroa,Verdi J. DiSesa,Loren F. Hiratzka,Adolph M. Hutter,Michael E. Jessen,Ellen C. Keeley,Stephen J. Lahey,Richard A. Lange,Martin J. London,Michael J. Mack,Manesh R. Patel,John D. Puskas,Joseph F. Sabik,Ola A. Selnes,David M. Shahian,Jeffrey C. Trost,Michael D. Winniford,Alice K. Jacobs,Jeffrey L. Anderson,Nancy M. Albert,Mark A. Creager,Steven M. Ettinger,Robert A. Guyton,Jonathan L. Halperin,Judith S. Hochman,Frederick G. Kushner,E. Magnus Ohman,William G. Stevenson,Clyde W. Yancy +33 more
TL;DR: The current and former chairs and vice-chairs of the FACC are: David Hillis, MD, FACC, Chair, Peter K. Smith,MD, F ACC, Vice Chair*, and Ola Selnes, PhD, PhD.
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European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
Joep Perk,Guy De Backer,Helmut Gohlke,Ian D. Graham,Zeljko Reiner,W. M. Monique Verschuren,Christian Albus,Pascale Benlian,Gudrun Boysen,Renata Cifkova,Christi Deaton,Shah Ebrahim,Miles Fisher,Giuseppe Germanò,Richard J. Hobbs,Arno W. Hoes,Sehnaz Karadeniz,Alessandro Mezzani,Eva Prescott,Lars Rydén,Martin Scherer,Mikko Syvänne,Wilma J.M. Scholte op Reimer,Christiaan J. Vrints,David R. Wood,José Luis Zamorano,Faiez Zannad +26 more
TL;DR: Lékařská fakulta Univerzity Karlovy a Všeobecná fackultní nemocnice, Praha, Česká republika ČESKÁ KARDIOLOGICKÁ SPOLEČNOST the CZECH SOCIETY of CARDIOLOGY.
Journal ArticleDOI
2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery
L. David Hillis,Peter K. Smith,Jeffrey L. Anderson,John A. Bittl,Charles R. Bridges,John G. Byrne,Joaquin E. Cigarroa,Verdi J. DiSesa,Loren F. Hiratzka,Adolph M. Hutter,Michael E. Jessen,Ellen C. Keeley,Stephen J. Lahey,Richard A. Lange,Martin J. London,Michael J. Mack,Manesh R. Patel,John D. Puskas,Joseph F. Sabik,Ola A. Selnes,David M. Shahian,Jeffrey C. Trost,Michael D. Winniford,Alice K. Jacobs,Nancy M. Albert,Mark A. Creager,Steven M. Ettinger,Robert A. Guyton,Jonathan L. Halperin,Judith S. Hochman,Frederick G. Kushner,E. Magnus Ohman,William G. Stevenson,Clyde W. Yancy,David R. Holmes,John C. Lewin,Janet S. Wright,Charlene May,Erin A. Barrett,Lisa Bradfield,Debjani Mukherjee,Sue Keller,Maria Koinis,Ralph L. Sacco,Nancy J. Brown,Rose Marie Robertson,Gayle R. Whitman,Cheryl L. Perkins +47 more
TL;DR: Alice K. Jacobs,MD, FACC, FAHA, Chair Jeffrey L. Anderson, MD, F ACC, FAH, Chair-Elect Nancy Albert, PhD, CCNS, CCRN,FAHA, chair-Elect.
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Collaborative care for depression and anxiety problems
Janine Archer,Peter Bower,Simon Gilbody,Karina Lovell,David Richards,Linda Gask,Chris Dickens,Peter A. Coventry +7 more
TL;DR: Collaborative care is associated with significant improvement in depression and anxiety outcomes compared with usual care, and represents a useful addition to clinical pathways for adult patients with depression and Anxiety.
References
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