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Depression screening with patient-targeted feedback in cardiology: DEPSCREEN-INFO randomised clinical trial
Bernd Löwe1, Stefan Blankenberg2, Karl Wegscheider2
1Bernd Löwe, MD, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg; Stefan Blankenberg, MD, University Heart Centre, University Medical Centre Hamburg-Eppendorf, Hamburg; Karl Wegscheider, PhD, Department of Biostatistics and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg; Hans-Helmut König, MD MPH, Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg; Dirk Walter, MD, Cardiologicum Hamburg, Hamburg; Alexandra M. Murray, DPhil, Benjamin Gierk, MSc, Sebastian Kohlmann, PhD, Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf and Schön Klinik Hamburg Eilbek, Hamburg, Germany b.loewe@uke.de.
Background:
International guidelines advocate depression screening in patients with coronary heart disease (CHD) and other chronic illnesses, but evidence is lacking.
Aims:
To test the differential efficacy of written patient-targeted feedback v. no written patient feedback after depression screening.
Method:
Patients with CHD or hypertension from three cardiology settings were randomised and screened for depression (ClinicalTrials.gov Identifier: NCT01879111). Compared with the control group, where only cardiologists received written feedback, in the intervention group both cardiologists and patients received written feedback regarding depression status. Depression severity was measured 1 month (primary outcome) and 6 months after screening.
Results:
The control group (n = 220) and the patient-feedback group (n = 155) did not differ in depression severity 1 month after screening. Six months after screening, the patient-feedback group showed significantly greater improvements in depression severity and was twice as likely to seek information about depression compared with the control group.
Conclusions:
Patient-targeted feedback in addition to screening has a significant but small effect on depression severity after 6 months and may encourage patients to take an active role in the self-management of depression.
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