A Critical Review and Local Audit of the Prevalence of Mental Ill-Health in Heart Failure Patients
Heart Failure and mental ill-health
Introduction: A systematic review and meta-analysis of randomised controlled trials examining coronary heart disease and depression comorbidity. The number of useable randomised controlled trials (RCT) that specifically assess heart failure and depression is limited.
Aim: To establish if depression results in poor adherence to therapy in patients with coronary heart disease. To review the available data and explore the current interventions employed to improve coronary heart disease prognosis with depression comorbidity. To systematically review the efficacy of multidisciplinary shared care for depression in adults who have heart disease.
Method: This concept scoping study was conducted in two phases; the first was a systematic review of the literature and the second part was local data analysis. Statistical analysis was performed using RevMan® V.5.3 (Cochrane Community).
Findings: Patient who received multidisciplinary collaborative care showed significantly reduced major adverse cardiac outcomes in patients with cardiovascular diseases. They also demonstrated higher rates of self-reported remission of depression. The review also showed end point mortality after PCI was associated with patients having depression. Local population data showed that 26% of heart failure patients had mental ill health comorbidity, however only 12% had a formal diagnosis recorded.
Conclusion: Depression is associated with poor cardiac outcomes in patients with coronary artery disease. It is widespread in patients with cardiovascular disease and must be screened for throughout the management plan.
2. Samartzis L, Dimopoulos S, Tziongourou M, Nanas S. Effect of psychosocial interventions on quality of life in patients with chronic heart failure: a meta-analysis of randomized controlled trials. Journal of Cardiac failure. 2013. 19:125–34.
3. Meijer A, Conradi H, Bos E, Thombs B, Van Melle J, De Jonge P. Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis of 25 years of research. Gen Hosp Psychiatry 2011. 33:203–16.
4. Baumeister H, Hutter N, Bengel J. Psychological and pharmacological interventions for depression in patients with diabetes mellitus— a systematic Cochrane review. Diabetic Medicine. 2014. 31:773–86
5. Berkman L, Blumenthal J, Burg M, Carney M, Catellier D, Cowan J, Czajkowski M, et al. Enhancing Recovery in Coronary Heart Disease Patients Investigators (ENRICHD). Effects of treating depression and low perceived social support on clinical events after myocardial infarction: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) randomized trial. JAMA. 2003. 289: 3106–3116.
6. Linden W. How many meta-analyses does it take to settle a question? Psychosomatic Medicine. 2013. 75: 332–334.
7. Richards D, Hill J, Gask L, Lovell K, Chew-Graham C, Bower P, Cape J, et al. Clinical effectiveness of collaborative care for depression in UK primary care (CADET): cluster randomised controlled trial. 2013. The BMJ. doi: https://doi.org/10.1136/bmj.f4913.
8. Sanchez K. Collaborative care in real-world settings: barriers and opportunities for sustainability. 2017. Patient preference and adherence. 11: 71-74.
9. Tully P and Baumeister H. Collaborative care for comorbid depression and coronary heart disease: a systematic review and meta-analysis of randomised controlled trials. 2015. BMJ Open. e009128. doi:10.1136/bmjopen-2015- 009128.
10. Morgan M, Coates M, Dunbar J, Reddy P, Schlicht K, Fuller J. The TrueBlue model of collaborative care using practice nurses as case managers for depression alongside diabetes or heart disease: a randomised trial. 2013. BMJ Open. doi: 10.1136/bmjopen-2012-002171.
11. Rollman B, Belnap B, LeMenager M, Mazumdar S, Schulberg H, Reynolds C. The Bypassing the Blues treatment protocol: stepped collaborative care for treating post-CABG depression. Psychosomatic Medicine. 2009. 71: 217-230.
12. Davidson K, Bigger J, Burg M, Carney R, Chaplin W, Czajkowski S, Dornelas E, et al. Centralized, stepped, patient preference-based treatment for patients with post-acute coronary syndrome depression: CODIACS vanguard randomized controlled trial. 2013. JAMA Internal medicine. 173: 997-1004
13. Huffman J, Mastromauro C, Beach S, Celano C, DuBois C, Healy B, Suarez L, et al. Collaborative care for depression and anxiety disorders in patients with recent cardiac events: The Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial. 2014. JAMA Internal Medicine. 174: 927-935
14. Davidson K, Rieckmann N, Clemow L, Schwartz J, Shimbo D, Medina V, Albanese G, et al. Enhanced Depression Care for Patients with Acute Coronary Syndrome and Persistent Depressive Symptoms; Coronary Psychosocial Evaluation Studies Randomized Controlled Trial (COPES). 2010. Archives of Internal Medicine. 170: 600-608
15. Huffman J, Mastromauro C, Sowden G, Wittmann C, Rodman R, Januzzi J. A collaborative care depression management program for cardiac inpatients: depression characteristics and in-hospital outcomes (SUCCEED). 2011. Psychosomatics. 52:26–33
16. De Jager T, Dulfer K, Radhoe S, Bergmann M, Daemen J, Van Domburg R, Lenzen M, Utens E. Predictive value of depression and anxiety for long-term mortality: differences in outcome between acute coronary syndrome and stable angina pectoris. International journal of cardiology. 2018. 250: 43-48
17. Van Dijk M, Utens E, Dulfer K, Al-Qezweny M, van Geuns R, Daemen J, van Domburg R. Depression and anxiety symptoms as predictors of mortality in PCI patients at 10 years of follow-up. European Journal of Preventative Cardiology. 2016. 23:552–558.
18. Meyer T, Hussein S, Lange H, Herrmann-Lingen C. Transient impact of baseline depression on mortality in patients with stable coronary heart disease during long-term follow-up. Clinical Research in Cardiology. 2014;103:389–395
19. Wang Z, Guo M, Si TM, Jiang M, Liu S, Liu Y, Zhao Y, et al. Association of depression with adverse cardiovascular events after percutaneous coronary intervention. Coronary Artery Disease. 2013. 24:589–595
20. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613. doi:10.1046/j.1525-1497.2001.016009606.x.
21. Beck, A.T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561-571.
22. Snaith, R.P. The Hospital Anxiety and Depression Scale. Health Qual Life Outcomes 1, 29 (2003). https://doi.org/10.1186/1477-7525-1-29.
23. Sheehan DV, Lecrubier Y, Sheehan KH, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–57.
This work is licensed under a Creative Commons Attribution 4.0 International License.