Collaborative care for comorbid depression and coronary heart disease: a systematic review and meta-analysis of randomised controlled trials

Abstract: Objectives:To systematically review the efficacy of collaborative care (CC) for depression in adults with coronary heart disease (CHD) and depression.Design:Systematic review and meta-analysis.Data sources:Electronic databases (Cochrane Central Register of Controlled Trials MEDLINE, EMBASE, PsycINFO and CINAHL) were searched until April 2014.Inclusion criteria:Population, depression comorbid with CHD; intervention, randomised controlled trial (RCT) of CC; comparison, either usual care, wait-list control group or no further treatment; and outcome, (primary) major adverse cardiac events (MACE),(secondary) standardised measure of depression, anxiety, quality of life (QOL) and cost-effectiveness.Data extraction and analysis:RevMan V.5.3 was used to synthesise the data as risk ratios (RRs), ORs and standardised mean differences (SMD) with 95% CIs in random effect models.Results:Six RCTs met the inclusion criteria and comprised 655 participants randomised to CC and 629 participants randomised to the control group (total 1284). Collaborative depression care led to a significant reduction in MACE in the short term (threetrials, RR 0.54; 95% CI 0.31 to 0.95, p=0.03) that was not sustained in the longer term. Small reductions in depressive symptoms were evident in the short term (6 trials, pooled SMD−0.31; 95% CI −0.43 to −0.19,p<0.00001) and depression remission was more likely to be achieved with CC (5 trials, OR 1.77; 95% CI 1.28 to 2.44, p=0.0005). Likewise, a significant effect was observed for anxiety symptoms (SMD −0.36) andmental QOL (SMD 0.24). The timing of the intervention was a source of between-group heterogeneity for depression symptoms (betweengroups p=0.04, I²=76.5%).Conclusions:Collaborative depression care did not lead to a sustained reduction in the primary MACE end point. Small effects were observed for depression, depression remission, anxiety and mental QOL.Trials registration number: PROSPERO CRD42014013653

Angaben zum Objekt

• Standort: Deutsche Nationalbibliothek Frankfurt am Main
• Umfang: Online-Ressource
• Sprache: Englisch
• Anmerkungen: BMJ Open. 5, 12 (2015), e009128, DOI 10.1136/bmjopen-2015-009128, issn: 2044-6055 ; IN COPYRIGHT http://rightsstatements.org/page/InC/1.0 rs

Klassifikation und Themen

• Klassifikation: Soziale Probleme, Sozialdienste, Versicherungen

Beteiligte, Orts- und Zeitangaben

• Ereignis: Veröffentlichung
• (wo): Freiburg
• (wer): Universität
• (wann): 2015
• Urheber: Tully, Phillip J. ; Baumeister, Harald
• Beteiligte Personen und Organisationen: Institut für Psychologie ; Wirtschafts- und Verhaltenswissenschaftliche Fakultät ; Albert-Ludwigs-Universität Freiburg

Weitere Informationen

• DOI: 10.1136/bmjopen-2015-009128
• URN: urn:nbn:de:bsz:25-freidok-120670
• Rechteinformation: Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Letzte Aktualisierung: 15.08.2025, 07:34 MESZ