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

Adrienne O'Neil, Barr Taylor, David L. Hare, Kristy Sanderson, Sheila Cyril, Kamalesh Venugopal, Bianca Chan, John J. Atherton, Anna Hawkes, Darren L. Walters, Brian Oldenburg

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20 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1111-1120
Number of pages10
JournalEuropean Journal of Preventive Cardiology
Volume22
Issue number9
DOIs
Publication statusPublished - 1 Sep 2015

Keywords

  • acute coronary syndrome
  • cardiac
  • cognitive behaviour therapy
  • Depression
  • tele-health

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