Depression Clinical Trial
Official title:
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.
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.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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