Abstract
Background
Depression is common among patients with heart failure (HF) and can impact patients’
outcomes. In this study, we evaluated the rates of psychotherapy referrals for patients
with HF with depression.
Methods and Results
Using the National Ambulatory Medical Care Survey from 2008 to 2018, we examined visits
for patients with depression and concurrent HF or coronary artery disease. We estimated
the likelihood of referral for psychotherapy using survey weights to provide nationally
representative estimates. Among 1797 visits for patients with HF or coronary artery
disease and depression, only 9.4% (95% confidence interval 7.2%–12.2%) were referred
for psychotherapy, including mental health counseling and stress management. Rates
of referral were lowest among patients with depression and HF at 7.5% (95% confidence
interval 4.1%–13.2%). The odds of referral decreased over the years from 2008 to 2018
(odds ratio per additional year 0.87, 95% confidence interval 0.77–0.98, P = .022), with referral rates in 2008 of 12.8% compared with 4.8% in 2018.
Conclusions
In this nationally representative study of ambulatory visits, patients with HF and
depression were referred for psychotherapy in only 7.5% of visits and referral rates
have decreased over the years. Magnifying the value of psychotherapy and increasing
referral rates are essential steps to improve care for patients with HF with depression.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Cardiac FailureAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Depression in heart failure.J Am Coll Cardiol. 2006; 48: 1527-1537https://doi.org/10.1016/jjacc.2006.06.055
- Elevated depression symptoms predict long-term cardiovascular mortality in patients with atrial fibrillation and heart failure.Circulation. 2009; 120: 134-140https://doi.org/10.1161/CIRCULATIONAHA.109.851675
- Depression and multiple rehospitalizations in patients with heart failure: depression and rehospitalization in heart failure.Clin Cardiol. 2016; 39: 257-262https://doi.org/10.1002/clc.22520
- Sertraline treatment of major depression in patients with acute MI or unstable angina.JAMA. 2002; 288 (Erratum in: JAMA 2002 Oct 9;288(14):1720. PMID:12169073): 701-709https://doi.org/10.1001/jama.288.6.701
- Safety and efficacy of sertraline for depression in patients with heart failure.J Am Coll Cardiol. 2010; 56: 692-699https://doi.org/10.1016/j.jacc.2010.03.068
- Cognitive behavior therapy for depression and self-care in heart failure patients: a randomized clinical trial.JAMA Intern Med. 2015; 175: 1773https://doi.org/10.1001/jamainternmed.2015.5220
National Center for Health Statistics. National Ambulatory Medical Care Survey (NAMCS) Datasets and Documentation. https://www.cdc.gov/nchs/ahcd/datasets_documentation_related.htm. Accessed April 2022.
- Depression and late mortality after myocardial infarction in the Enhancing Recovery in Coronary Heart Disease (ENRICHD) study.Psychosom Med. 2004; 66: 466-474https://doi.org/10.1097/01.psy.0000133362.75075.a6
Article info
Publication history
Published online: December 12, 2022
Accepted:
December 6,
2022
Received in revised form:
November 27,
2022
Received:
October 25,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
