Depression Care for Hospitalized Coronary Heart Disease Patients: Prospective Cohort Study (CDCare)
The aims of this prospective, observational study are to assess the current use of depression care in Coronary Heart Disease (CHD) patients, and to provide estimates for the resources needed to implement guideline-oriented depression health care acceptable to CHD patients with comorbid depression.
Coronary Heart Disease
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Depression Care for Hospitalized Coronary Heart Disease Patients: Bridging the Gap Between Guidelines and Reality|
- Percentage of participants in depression care during the 12 months after hospitalization [ Time Frame: Baseline and within one year after hospitalization ] [ Designated as safety issue: No ]Assessed via questionnaire (self-reported psychotherapy for depression and / or antidepressant medication and / or other treatment) at baseline, 1month, 6 month and 12 months Additionally, antidepressant medication prescription will be assessed at baseline via chart review (antidepressant medication at admission and discharge)
- Percentage of participants reporting current utilization of mental health care and satisfaction with mental health care [ Time Frame: Baseline and within one year after hospitalization ] [ Designated as safety issue: No ]
Current mental health care utilization is assessed via questionnaire with a single item ("yes or no").
Satisfaction with current mental health care is assessed via questionnaire with a single continuous rating item (ranging from "very satisfied to not at all satisfied") at baseline and all follow-up assessments (1mo, 6mo and 12months)
- Patient preferences for different providers and settings of mental health care services, as indicated by the percentage of patients who indicate actual receipt of or potential willingness to receive mental health care by specific providers and settings [ Time Frame: Baseline and within one year after hospitalization ] [ Designated as safety issue: No ]Assessed via questionnaire with at baseline and all follow-up assessments (1mo, 6mo and 12months). A list of mental health care providers (e.g., general practitioner, psychotherapist, psychiatrist, ...) is provided and for each, patients are asked to indicated whether they currently receive mental health care from any provider and if not, if they would be willing to reciev mentral health care by that provider, should they ever be in need (answer options "yes, maybe, no").
- Percentage of patients in need for depression health care according to existing recommendations [ Time Frame: Baseline and within one year after hospitalization ] [ Designated as safety issue: No ]
Baseline: Percentage of patients with a current Major Depressive Episode as assessed via the Composite International Diagnostic Interview (CIDI).
6 months assessment: percentage of patients with a current Major Depressive Episode as assessed via the Composite International Diagnostic Interview (CIDI) - this will only be conducted in a subsample of 300 consecutive participants.
Follow-up assessments: percentage of patients with persistently elevated depressive symptoms as indicated by a score of >=10 on the Patient Health Questionnaire (PHQ-9) at baseline and the follow-up assessments.
|Study Start Date:||June 2012|
|Estimated Study Completion Date:||August 2015|
|Estimated Primary Completion Date:||July 2015 (Final data collection date for primary outcome measure)|
In patients with established CHD, unipolar depression is up to three times more prevalent than in the general population and increases the risk for coronary events and mortality, higher health care consumption and decreased quality of life. Most hospitals in Germany have a unique infrastructure of psychiatric, psychosomatic and psychosocial services for CHD patients (psychiatric/psychosomatic consultation liaison services and a wide network of inpatient or outpatient cardiac rehabilitation centers). However, as of today, little is known about the current use and acceptability of depression health care from the perspective of CHD patients.
This project has two main aims:
- to assess the current use of depression care in CHD patients who are hospitalized or receive ambulatory care at a cardiology clinic
- to provide estimates for the resources needed to implement guideline-oriented depression health care acceptable to CHD patients with comorbid depression.
Specifically, the investigators will assess
- rates of and satisfaction with depression health care use in hospitalized CHD patients within one year after hospitalization
- perceived need for depression care and patient preferences for different types, settings and providers of these services
- correlates of depression health care use and patient preferences
- the amount of patients in need for depression health care according to existing recommendations
The secondary objective is to assess direct and indirect costs associated with depressive symptoms and depression care use across 1 year (as indicated by quality of life, event-free survival, productivity, and health care costs).
Please refer to this study by its ClinicalTrials.gov identifier: NCT01626027
|Medizinische Klinik m. Schwerpunkt Kardiologie, Charité Universitätsmedizin|
|Berlin, Germany, 13353|
|Principal Investigator:||Jacqueline Müller-Nordhorn, MD, DPH||Charité Universitätsmedizin|