Long-term efficacy of a tele-health intervention for acute coronary syndrome patients with depression: 12-month results of the MoodCare randomized controlled trial. (September 2015)

• Record Type: Journal Article
• Authors: O'Neil, Adrienne; Taylor, Barr; Hare, David L; Sanderson, Kristy; Cyril, Sheila; Venugopal, Kamalesh; Chan, Bianca; Atherton, John J; Hawkes, Anna; Walters, Darren L; Oldenburg, Brian
• Is Part Of: European journal of preventive cardiology. Volume 22:Number 9(2015)
• Page Start: 1111
• Page End: 1120
• Publication Date: 2015-09
• Subjects: Depression -- acute coronary syndrome -- tele-health -- cognitive behaviour therapy -- cardiac; Cardiovascular system -- Diseases -- Prevention -- Periodicals; Cardiac patients -- Rehabilitation -- Periodicals; 616.12
• DOI: 10.1177/2047487314547655
• Languages: English
• ISSNs: 2047-4873

Abstract

Background: Depression is common after a cardiac event; however it often remains untreated. Previously, we reported the efficacy and feasibility of a 6-month tele-health programme (MoodCare), which integrates depression management into a cardiovascular disease (CVD) risk reduction programme for Acute Coronary Syndrome (ACS) patients with low mood. Here, we evaluate the long-term efficacy of the programme at 12-month follow-up. Design: A two-arm, parallel, randomized design to compare the long-term effects of 'MoodCare' (n = 61) to usual care (UC) (n = 60) at 12 months. Method: 121 ACS patients recruited from six hospitals in Victoria and Brisbane, Australia were randomized to a telephone-delivered cognitive behavioural therapy and risk-reduction programme or usual medical care. Mixed-model repeated measurements (MMRM) analysis was applied with results expressed as estimated marginal mean changes in depression and health-related quality of life (HRQOL) outcomes by group. Results: After 12 months, treatment effects were observed for those with major depressive disorder (MDD) for PHQ-9 depression (MoodCare: mean score: 6.5; 95% CI: 4.9–8.0 versus UC: 9.3; 95% CI: 7.7–10.9, p = 0.012)) and SF-12 mental health scores (MoodCare: 42.5; 95% CI: 39.8–45.2 versus UC: 36.8; 95% CI: 34.1–39.6, p = 0.005). No beneficial treatment effects were observed in those with no MDD at baseline. Conclusion: After 12 months, MoodCare was superior to UC for improving mental health outcomes for those with a clinical diagnosis of major depression. Our findings support the implementation of depression-based interventions for cardiac patients with a clinical diagnosis of depression and provide evidence of longer term efficacy to one year.