Depression screening and referral in cardiac wards: A 12-month patient trajectory

Area of Science:

• Cardiology
• Psychiatry
• Health Services Research

Background:

• Depression is prevalent in coronary heart disease (CHD) patients, significantly impacting their quality of life, morbidity, and mortality.
• Identifying and managing depression in CHD is crucial for improving patient outcomes.

Purpose of the Study:

• To investigate the 12-month psychosocial outcomes of patients with CHD screened positive for depression in an acute cardiac ward.
• To assess the trajectory of depression, anxiety, wellbeing, and social support in this patient population.

Main Methods:

• A prospective cohort study involving 212 CHD patients admitted to acute cardiac wards.
• Psychosocial outcomes were assessed using a validated screening tool before discharge and at 1, 3, 6, and 12 months post-discharge.
• Linear mixed models were employed to analyze the data.

Main Results:

• Patients screened at 'moderate to high' risk for depression exhibited significantly higher depression and anxiety levels, and lower wellbeing and social support compared to those at 'no to low' risk.
• Depression and wellbeing levels remained relatively stable throughout the 12-month follow-up period.
• No significant psychological differences were observed between patients receiving surgical versus medical treatment.

Conclusions:

• A nurse-administered depression screening tool demonstrates effectiveness and predictive validity in identifying at-risk CHD patients.
• Screening and referral alone are insufficient for optimal disease management; a collaborative care model is recommended.
• Integrated care pathways involving family and primary care are essential for comprehensive management of CHD patients with depression.