ACC: Patient Preference-Based Treatment Improves Depression

Findings in patients following post-acute coronary syndrome; program could be cost-neutral

TUESDAY, March 12 (HealthDay News) -- A centralized, patient preference-based program for depression care decreases symptoms in patients with post-acute coronary syndrome (ACS), according to a study published online March 7 in JAMA Internal Medicine to coincide with presentation at the annual meeting of the American College of Cardiology, held from March 9 to 11 in San Francisco.

Karina W. Davidson, Ph.D., from Columbia University in New York City, and colleagues randomized 150 patients with elevated depressive symptoms (Beck Depression Inventory [BDI] score of 10 or more; two to six months after an ACS) to receive either six months of centralized depression care (patient preference for problem-solving treatment given via telephone or the Internet, pharmacotherapy, both, or neither), stepped every six to eight weeks (active-treatment group), or locally determined depression care after physician notification about the patient's depressive symptoms (usual-care group).

The researchers found that depressive symptoms decreased significantly more in the active-treatment group than in the usual-care group (differential change between groups, −3.5 BDI points). Overall health care estimated costs were not significantly different between the two groups (difference adjusting for confounding, −$325), although mental health care estimated costs were higher for active treatment than for usual care.

"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 authors write.

One author disclosed financial ties to Forest Laboratories and Pfizer.

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