Abstract 225: A Depression Quality Program and Cardiovascular Disease: Assessing the Impact on Care
| العنوان: | Abstract 225: A Depression Quality Program and Cardiovascular Disease: Assessing the Impact on Care |
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| المؤلفون: | Amanda Malecky, Linda Gordon, Nicole Ansani, Andrew D. Althouse |
| المصدر: | Circulation: Cardiovascular Quality and Outcomes. 10 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | medicine.medical_specialty, Quality management, business.industry, media_common.quotation_subject, Disease, Depression screening, medicine.disease, Coronary artery disease, Physical therapy, medicine, Quality (business), Cardiology and Cardiovascular Medicine, Intensive care medicine, business, Depression (differential diagnoses), media_common |
| الوصف: | Background: Data demonstrate an adverse association between depression and coronary artery disease prognosis. Therefore, a depression screening program was initiated in the catheterization (cath) lab. The goals were to improve HEDIS depression compliance rates and determine the impact on clinical outcomes. Methods: Adult patients in an inpatient cath lab from 3 cardiology practices were screened for enrollment in a randomized controlled trial. All cath lab patients received a PHQ-9 depression screener. Those who screened positive for depression (score ≥ 10) were randomized to intervention or usual care. The usual care group received a follow-up phone call to re-administer the PHQ-9 at 6-8 weeks and within 210 days of discharge. The intervention group was administered the PHQ-9 and received intensive education at baseline, 6-8 weeks, and within 210 days of discharge. Education included targeted depression information with a mental health care provider and comprehensive disease management education with a cardiovascular nurse practitioner. Outcomes included: differences in HEDIS depression goal attainment; depression response/remission rates; and cardiovascular goals. Differences between groups were tested using chi-squared tests (categorical variables) and t-tests (continuous variables). Results: Baseline characteristics were similar between control (N=43) and intervention (N=40) groups, with the exception of significantly fewer African American patients in the control group (N=2, 4.7%) vs intervention (N=9, 22.5%). Changes in HEDIS goal attainment show that patients in the intervention group were slightly more likely to be referred to a provider to address depression (95.0% vs 86.0%, p=0.314), or receive meds for depression (65.0% vs 51.2%, p=0.219), but these differences are not statistically significant. More patients in the intervention group refused meds for depression compared to control (15.0% vs. 2.3%, p=0.041); have received blood work (65.0% vs 41.9%, p=0.030); and have received follow-up within 210 days (82.5% vs 46.5%, p Conclusions: These data demonstrate improvements in attaining a surrogate outcome measure of quality (HEDIS goals); however, this does not appear to translate to a significant clinical impact. Quality measures may need to be continuously reassessed to ensure efficiency and effectiveness of care. |
| تدمد: | 1941-7705 1941-7713 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_________::edf6b0de8ceb01efef91793715cc360c https://doi.org/10.1161/circoutcomes.10.suppl_3.225 |
| رقم الأكسشن: | edsair.doi...........edf6b0de8ceb01efef91793715cc360c |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19417705 19417713 |
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