Study: Telemedicine benefits cardiac patients with depression

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Collaborative care delivered via telephone benefitted patients with depression after coronary artery bypass graft (CABG) surgery, according to a study recently published in Journal of the American Medical Association. The patients who received collaborative care over the phone experienced greater improvement in quality of life, physical functioning, and mood than those who received usual care.

Internist Bruce L. Rollman, MD, MPH, of the University of Pittsburgh School of Medicine, and colleagues conducted a randomized trial of 302 post-CABG patients with depression (150 of whom received collaborative care) and a comparison group of 151 randomly sampled post-CABG patients without depression. For patients receiving collaborative care, a nurse care manager telephoned them to review their psychiatric history, provide basic psychoeducation about depression and its effect on cardiac disease, and describe treatment options over eight months. The patients’ primary care physicians worked with the nurses, who were supervised by a primary care physician and psychiatrist from the study.

Typically, as many as half of the patients who undergo CABG report symptoms of depression after surgery and are also more likely to experience a decreased health-related quality of life and functional status, according to the article.

The researchers found that, overall, patients treated with collaborative care reported a 50 percent or greater reduction in mood symptoms from baseline to eight-month follow-up versus 29.6 percent of patients in usual care. “Men with depression were particularly likely to benefit from the intervention,” the authors wrote.

Patients receiving collaborative care did not experience the same mean level of health-related quality of life and physical functioning as the non-depressed comparison group, they added. More research is needed so that improved treatments can be developed for woman and those whose depression is resistant to current treatments, the investigators concluded.