Collaborative care for comorbid depression and coronary heart disease: a systematic review and meta-analysis of randomised controlled trials
Identifieur interne : 003027 ( Main/Exploration ); précédent : 003026; suivant : 003028Collaborative care for comorbid depression and coronary heart disease: a systematic review and meta-analysis of randomised controlled trials
Auteurs : Phillip J. Tully [Allemagne, Australie, France] ; Harald Baumeister [Allemagne]Source :
- BMJ Open [ 2044-6055 ] ; 2015.
Descripteurs français
- KwdFr :
- Anxiété (), Anxiété (diagnostic), Biais de publication, Comorbidité, Comportement coopératif, Dépression (), Dépression (diagnostic), Essais contrôlés randomisés comme sujet, Humains, Maladie des artères coronaires (), Prise en charge personnalisée du patient (organisation et administration), Psychothérapie (), Qualité de vie, Équipe soignante (organisation et administration).
- MESH :
- diagnostic : Anxiété, Dépression.
- organisation et administration : Prise en charge personnalisée du patient, Équipe soignante.
- Anxiété, Biais de publication, Comorbidité, Comportement coopératif, Dépression, Essais contrôlés randomisés comme sujet, Humains, Maladie des artères coronaires, Psychothérapie, Qualité de vie.
English descriptors
- KwdEn :
- Anxiety (diagnosis), Anxiety (therapy), Case Management (organization & administration), Comorbidity, Cooperative Behavior, Coronary Artery Disease (complications), Depression (diagnosis), Depression (therapy), Humans, Patient Care Team (organization & administration), Psychotherapy (methods), Publication Bias, Quality of Life, Randomized Controlled Trials as Topic.
- MESH :
- complications : Coronary Artery Disease.
- diagnosis : Anxiety, Depression.
- methods : Psychotherapy.
- organization & administration : Case Management, Patient Care Team.
- therapy : Anxiety, Depression.
- Comorbidity, Cooperative Behavior, Humans, Publication Bias, Quality of Life, Randomized Controlled Trials as Topic.
Abstract
To systematically review the efficacy of collaborative care (CC) for depression in adults with coronary heart disease (CHD) and depression.
Systematic review and meta-analysis.
Electronic databases (Cochrane Central Register of Controlled Trials MEDLINE, EMBASE, PsycINFO and CINAHL) were searched until April 2014.
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.
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.
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 (three trials, 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) and mental QOL (SMD 0.24). The timing of the intervention was a source of between-group heterogeneity for depression symptoms (between groups p=0.04, I2=76.5%).
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.
PROSPERO CRD42014013653.
Url:
DOI: 10.1136/bmjopen-2015-009128
PubMed: 26692557
PubMed Central: 4691772
Affiliations:
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Tully</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Rehabilitation Psychology and Psychotherapy</addr-line>,<institution>Institute of Psychology, University of Freiburg</institution>,<addr-line>Freiburg</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><institution>Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Medicine, The University of Adelaide</institution>,<addr-line>Adelaide, South Australia</addr-line>,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>INSERM, U897-Epidemiology and Biostatistics</institution>,<addr-line>Bordeaux</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Baumeister, Harald" sort="Baumeister, Harald" uniqKey="Baumeister H" first="Harald" last="Baumeister">Harald Baumeister</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Rehabilitation Psychology and Psychotherapy</addr-line>,<institution>Institute of Psychology, University of Freiburg</institution>,<addr-line>Freiburg</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Faculty of Medicine, Medical Psychology and Medical Sociology,</addr-line><institution>University of Freiburg</institution>,<addr-line>Freiburg</addr-line>,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Anxiety (diagnosis)</term><term>Anxiety (therapy)</term><term>Case Management (organization & administration)</term><term>Comorbidity</term><term>Cooperative Behavior</term><term>Coronary Artery Disease (complications)</term><term>Depression (diagnosis)</term><term>Depression (therapy)</term><term>Humans</term><term>Patient Care Team (organization & administration)</term><term>Psychotherapy (methods)</term><term>Publication Bias</term><term>Quality of Life</term><term>Randomized Controlled Trials as Topic</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Anxiété ()</term><term>Anxiété (diagnostic)</term><term>Biais de publication</term><term>Comorbidité</term><term>Comportement coopératif</term><term>Dépression ()</term><term>Dépression (diagnostic)</term><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Maladie des artères coronaires ()</term><term>Prise en charge personnalisée du patient (organisation et administration)</term><term>Psychothérapie ()</term><term>Qualité de vie</term><term>Équipe soignante (organisation et administration)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronary Artery Disease</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Anxiety</term><term>Depression</term></keywords><keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Anxiété</term><term>Dépression</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Psychotherapy</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Prise en charge personnalisée du patient</term><term>Équipe soignante</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Case Management</term><term>Patient Care Team</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Anxiety</term><term>Depression</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Comorbidity</term><term>Cooperative Behavior</term><term>Humans</term><term>Publication Bias</term><term>Quality of Life</term><term>Randomized Controlled Trials as Topic</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Anxiété</term><term>Biais de publication</term><term>Comorbidité</term><term>Comportement coopératif</term><term>Dépression</term><term>Essais contrôlés randomisés comme sujet</term><term>Humains</term><term>Maladie des artères coronaires</term><term>Psychothérapie</term><term>Qualité de vie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>To systematically review the efficacy of collaborative care (CC) for depression in adults with coronary heart disease (CHD) and depression.</p></sec><sec><title>Design</title><p>Systematic review and meta-analysis.</p></sec><sec><title>Data sources</title><p>Electronic databases (Cochrane Central Register of Controlled Trials MEDLINE, EMBASE, PsycINFO and CINAHL) were searched until April 2014.</p></sec><sec><title>Inclusion criteria</title><p>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.</p></sec><sec><title>Data extraction and analysis</title><p>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.</p></sec><sec><title>Results</title><p>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 (three trials, 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) and mental QOL (SMD 0.24). The timing of the intervention was a source of between-group heterogeneity for depression symptoms (between groups p=0.04, I<sup>2</sup>=76.5%).</p></sec><sec><title>Conclusions</title><p>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.</p></sec><sec><title>Trials registration number</title><p>PROSPERO CRD42014013653.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Barth, J" uniqKey="Barth J">J Barth</name></author><author><name sortKey="Schumacher, M" uniqKey="Schumacher M">M Schumacher</name></author><author><name sortKey="Herrmann Lingen, C" uniqKey="Herrmann Lingen C">C Herrmann-Lingen</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Lichtman, Jh" uniqKey="Lichtman J">JH Lichtman</name></author><author><name sortKey="Froelicher, Es" uniqKey="Froelicher E">ES Froelicher</name></author><author><name sortKey="Blumenthal, Ja" uniqKey="Blumenthal J">JA Blumenthal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Samartzis, L" uniqKey="Samartzis L">L Samartzis</name></author><author><name 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Burg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Beach, Sr" uniqKey="Beach S">SR Beach</name></author><author><name sortKey="Januzzi, Jl" uniqKey="Januzzi J">JL Januzzi</name></author><author><name sortKey="Mastromauro, Ca" uniqKey="Mastromauro C">CA Mastromauro</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>France</li></country></list><tree><country name="Allemagne"><noRegion><name sortKey="Tully, Phillip J" sort="Tully, Phillip J" uniqKey="Tully P" first="Phillip J" last="Tully">Phillip J. Tully</name></noRegion><name sortKey="Baumeister, Harald" sort="Baumeister, Harald" uniqKey="Baumeister H" first="Harald" last="Baumeister">Harald Baumeister</name><name sortKey="Baumeister, Harald" sort="Baumeister, Harald" uniqKey="Baumeister H" first="Harald" last="Baumeister">Harald Baumeister</name></country><country name="Australie"><noRegion><name sortKey="Tully, Phillip J" sort="Tully, Phillip J" uniqKey="Tully P" first="Phillip J" last="Tully">Phillip J. Tully</name></noRegion></country><country name="France"><noRegion><name sortKey="Tully, Phillip J" sort="Tully, Phillip J" uniqKey="Tully P" first="Phillip J" last="Tully">Phillip J. Tully</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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