A simple telephonic intervention improves mood, physical functioning, and overall quality of life in patients who are depressed after heart bypass surgery.
Depression after heart surgery is often unrecognised. When a patient still has symptoms, such as pain, the physician usually orders some tests, sometimes often overlooking the obvious.
Researchers studied 302 post-coronary artery bypass graft (CABG) patients with depression (150 underwent intervention and 152 received the usual care) and a comparison group of 151 randomly sampled post-CABG patients without depression recruited between March 2004 and September 2007 and observed as outpatients until June 2008. They screened heart bypass patients for depression before they were discharged from the hospital. Patients screened to be positive were contacted again two weeks later when they were at home to see if their depression was persisting. If so, they were randomly allocated to receive an 8-month course of telephone-delivered collaborative care or usual care.
Patients in the collaborative care group received a workbook, mailed to them at home, which contained basic talk therapy approaches as well as recommendations for exercising, getting plenty of quality sleep, and staying connected socially. Antidepressants were provided if patients felt it necessary. Patients who were already taking antidepressants could have their dose changed or could switch to another medication, and suggestions were made for consults with local mental health specialists if patients were not improving. Trained nurse practitioners phoned the patients every other week at the start of the intervention and then once a month as the study progressed.
This simple intervention was found to be effective in relieving depression after heart bypass surgery. Patients who were depressed after having coronary artery bypass surgery saw improvements of at least 50 percent in their negative mood after participating in the intervention, compared with 29 percent of patients who received usual care. Depressed men benefited most and were far less likely to be re-hospitalised for heart-related causes than men who got usual care.
The researchers concluded that patients should be screened for depression after heart bypass surgery because it occurs in roughly 25 percent of cases and, as the results showed, treating depression can help in a faster recovery.