Navigation Links
Patients with post-ACS depression benefitted from active treatment in clinical trial
Date:3/8/2013

A clinical trial of patients with post-acute coronary syndrome (ACS, heart disease) depression finds that a centralized, patient-preference program decreased depressive symptoms and may be cost-neutral over time, according to a report published Online First by JAMA Internal Medicine, a JAMA Network publication. The study is being released early to coincide with its presentation at the American College of Cardiology's annual Scientific Sessions.

About 1.2 million Americans survive an ACS event every year and many of them have clinically significant and persistent depression. Post-ACS depression is also associated with an increased risk of ACS recurrence and with an increase in the relative risk of all-cause mortality, the authors write in the study background.

Karina W. Davidson, Ph.D., of the Columbia University College of Physicians & Surgeons, New York, and colleagues sought to determine the effects of providing post-ACS depression care on symptoms and health care costs in a multicenter randomized controlled trial.

A total of 150 patients were divided into two groups for six months of treatment. Of the patients, 73 were enrolled in the intervention group in which they could receive centralized depression care that was based on patient preference for problem-solving treatment given by telephone or the Internet, medication, both or neither. The other 77 patients were enrolled in the usual care group in which they were free to obtain depression from their primary care physician, cardiologist or any other health care practitioner, according to the study.

"For patients with post-ACS depression, active treatment had a substantial beneficial effect on depressive symptoms. This kind of depression care is feasible, effective and may be cost-neutral within six months; therefore, it should be tested in a large phase 3 pragmatic trial," the study notes.

According to study results, depressive symptoms decreased significantly more in the active treatment group than in the usual care group (differential change between groups, -3.51 BDI [Beck Depression Inventory] points. Mental health costs were higher for the active treatment group than for the usual care group (adjusted change, $687), while average hospital costs were lower in the intervention group (adjusted change, -$1010). As a result of the offset, overall health care estimated costs in the study intervention group were not statistically different than in the comparison group (adjusted change, -$325), according to the results.

"A large phase 3 trial would inform evidence-based depression treatment guidelines for patients with an ACS, and even has the tantalizing possibility of answering the important question of whether treating depression in patients with ACS lowers mortality and recurrence rates," the study concludes.

(JAMA Intern Med. Published online March 7, 2013. doi:10.1001/jamainternmed.2013.915. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: An author made a conflict of interest disclosure. The work was supported by grants from the National Institutes of Health (NIH), Bethesda, Md., and was supported in part by Columbia University's CTSA from the National Center for Advancing Translational Sciences/NIH. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Commentary: Benefits, Costs of Improving Depression Treatment for Patients With Heart Disease

In a related commentary, Gregory E. Simon, M.D., M.P.H., Group Health Cooperative, Seattle, writes: "In this issue of JAMA Internal Medicine, Davidson et al describe the benefits of an organized depression care program for outpatients experiencing significant symptoms of depression after acute coronary syndrome (ACS)."

"While the CODIACS [Comparison of Depression Interventions after Acute Coronary Syndrome] investigators conclude that the depression care program was 'cost neutral,' I would be more cautious in interpreting the finding of no significant difference in cost," Simon wrote.

"Instead of concluding that this depression care program is cost neutral, I would conclude that this sample is far too small to accurately estimate the effect of the program on use or cost of general medical services _ especially the highly variable category of inpatient medical costs," the study concludes.

(JAMA Intern Med. Published online March 7, 2013. doi:10.1001/jamainternmed.2013.925. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


'/>"/>

Contact: Elizabeth Streich
estreich@columbia.edu
212-305-3689
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Wayne State researcher gives new name to exhaustion suffered by cancer patients
2. Defibrillator Patients Who Lose Weight May Fare Worse
3. Tooth loss associated with cardiovascular risk factors in patients with chronic heart disease
4. Electronic discharge tool reduces hospital readmissions in heart failure patients
5. Deep Brain Stimulation shows promise for patients with chronic, treatment resistant Anorexia Nervosa
6. Brain Scans May Explain Thinking, Memory Problems in Some MS Patients
7. Study identifies new risk factor for heart disease among kidney dialysis patients
8. Focal therapy offers middle ground for some prostate cancer patients
9. Scans That Gauge Heart Scarring May Spot High-Risk Patients
10. Recon 2 modeling may help tailor treatments for patients with metabolic diseases, cancer
11. Jacksonville Periodontist, Dr. Richard E. Aguila, Now Fixes High Gum Lines with Crown Lengthening Procedures for His Florida Patients with Excessive Gums Showing
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/29/2017)... ... March 29, 2017 , ... Altima Technologies, Inc., ... network and data center assets and audio-video devices has recently updated its Visio ... shapes for free and download shapes and stencils from http://www.VisioStencils.com. , ...
(Date:3/29/2017)... Yorba Linda, Ca (PRWEB) , ... March 29, 2017 , ... ... treatment of a growing number of cancers and is touted to be the next ... of treatment, thus far, has been in the form of immune checkpoint inhibitors such ...
(Date:3/29/2017)... Richmond, VA (PRWEB) , ... March 29, 2017 , ... ... of its seventh North American office location in Richmond, Virginia, located at the Riverfront ... April 11, attended by Lieutenant Governor of Virginia Ralph S. Northam and Mayor of ...
(Date:3/28/2017)... YORK, NEW YORK (PRWEB) , ... March 28, ... ... breakthrough development, NTX Technology™, is the first technology to directly address the resolution ... Health Organization. NTX Technology™ is a patented compound of FDA and TTB approved ...
(Date:3/28/2017)... ... March 29, 2017 , ... Dr. Isabella Wentz, PharmD, FASCP, one of the ... titled The Thyroid Secret. Dr. Wentz talked about journey and research recently on a ... medication IS NOT the only solution to deal with thyroid disease. , Dr. ...
Breaking Medicine News(10 mins):
(Date:3/29/2017)... Research and Markets has announced the addition ... report to their offering. ... The ablation device global market is expected to ... 2023. Ablation is the minimally invasive therapeutic tissue ... or diseased tissue removal, to the removal of abnormally conducting cardiac ...
(Date:3/29/2017)... , March 29, 2017   Dynatronics ... today the appointment of Cynthia L. McHenry ... will be responsible for leading Dynatronics manufacturing, distribution, ... will report to Dynatronics, CEO Kelvyn H. ... concludes an extensive search process conducted by the ...
(Date:3/29/2017)... 29, 2017 FinancialBuzz.com News Commentary  ... Data published in a research report by Grand ... a value of USD 55.8 billion by 2025. The projection takes into ... and a more open approach towards cannabis products around the ... Florida , North Dakota , Ohio ...
Breaking Medicine Technology: