Abstract
Background
Depression is common after a cardiac event, yet there remain few approaches to management that are both effective and scalable.
Purpose
We aimed to evaluate the 6-month efficacy and feasibility of a tele-health program (MoodCare) that integrates depression management into a cardiovascular disease risk reduction program for acute coronary syndrome patients with low mood.
Methods
A two-arm, parallel, randomized design was used comprising 121 patients admitted to one of six hospitals for acute coronary syndrome.
Results
Significant treatment effects were observed for Patient Health Questionnaire 9 (PHQ9) depression (mean difference [change] = −1.8; p = 0.025; effect size: d = 0.36) for the overall sample, when compared with usual medical care. Results were more pronounced effects for those with a history of depression (mean difference [change] = −2.7; p = 0.043; effect size: d = 0.65).
Conclusions
MoodCare was effective for improving depression in acute coronary syndrome patients, producing effect sizes exceeding those of some face-to-face psychotherapeutic interventions and pharmacotherapy. (Trial Registration Number: ACTRN1260900038623.)
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Acknowledgments
This study was supported by an Australian Government Department of Health and Ageing Grant under the Sharing Health Care Initiative and a grant from beyondblue: the national depression and anxiety initiative. AO was supported by a postgraduate award from the Heart Foundation (PP 08 M4079) while undertaking this work and is currently supported by a fellowship from the National Health and Medical Research Council (NHMRC)(#1052865). KS is supported by an Australian Research Council (ARC) Future Fellowship (FT991524). We thank our coinvestigators Dr. Stephen Bunker, Professor Helen Christensen, Professor Ole Mortensen, and Professor Andrew Forbes. We also thank key staff at participating recruitment sites including Professor Linda Worrall-Carter and Associate Professor Karen Page. We gratefully acknowledge Janice Whetton, Stephen Edwards, and Dr. Megan De Souza for their contribution to the intervention and Dr. Leah Brennan for feedback on the original version of the manuscript. We also thank all study participants.
Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards
Authors O’Neil, Taylor, Sanderson, Cyril, Chan, Hawkes, Professor Jelinek, Venugopal, Atherton, Amerena, Grigg, Walters, and Oldenburg declare that they have no conflict of interest. DL Hare developed the CDS and has received research, fellowship, and consultancy funds from the National Health and Medical Research Council (NHMRC), the National Heart Foundation of Australia, the Austin Medical Research Foundation, beyondblue, and Diabetes Australia for the development and researching of this scale. He has also received payment for research projects, consultancies, travel, advisory board memberships, and lectures from industry including Abbott, Amgen, AstraZeneca, Biotronic, Bristol-Myers Squibb, Boehringer Ingelheim, CSL Biotherapies, Hoffmann-La Roche, Hospira, Lundbeck (Denmark), Medtronic, Menarini, Merck KA (Germany), Merck (US), MSD, Pfizer, Roche, Sanofi-Aventis, Servier, and Wyeth. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
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Trial Registration Number: ACTRN1260900038623
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O’Neil, A., Taylor, B., Sanderson, K. et al. Efficacy and Feasibility of a Tele-health Intervention for Acute Coronary Syndrome Patients with Depression: Results of the “MoodCare” Randomized Controlled Trial. ann. behav. med. 48, 163–174 (2014). https://doi.org/10.1007/s12160-014-9592-0
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DOI: https://doi.org/10.1007/s12160-014-9592-0