In the so-called Bypassing the Blues trial, 50 percent of patients who were depressed after having coronary artery bypass surgery saw improvements of at least 50 percent in their negative mood after participating in the intervention, compared with 29 percent of control patients who received usual care.
Dr. Bruce L. Rollman, from the University of Pittsburgh, explains. “Depression after heart surgery is often unrecognized. When a patient still has symptoms, such as pain, the physician will order another stress test or other heart test. We just want people to be aware of the impact of depression and that there are safe and effective treatments available.”
In the trial, researchers screened heart bypass patients for depression before they were discharged from the hospital. Screen-positive patients were contacted again two weeks later when they were at home to see if their depression was persisting. If so, they were randomly allocated to receive an eight-month course of telephone-delivered collaborative care or usual care.
Patients in the collaborative care group received a workbook, mailed to them at home, which contained basic talk therapy approaches as well as recommendations for exercising, getting plenty of quality sleep and staying connected socially. Antidepressants were also provided if patients felt it necessary.
Trained nurse practitioners phoned the patients every other week at the start of the intervention and then once a month as the study progressed. This simple intervention proved effective in relieving depression after heart bypass surgery, Rollman reported. Patients should be screened for depression, he said, because it occurs in roughly 25 percent of cases, and, as this study shows, treating depression can speed recovery.
The study findings are to be published in the Journal of the American Medical Association.