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Collaborative depression care for coronary heart disease patients: a clinical trial

Dr Phillip Tully, Institution: University of Adelaide

2019 Vanguard Grant

Years funded: 2020-2021


Collaborative depression care is standard practice in the USA and UK for coronary heart disease (CHD) and heart failure patients, however, this model of healthcare is uncommon in Australia. Consequently, the pragmatic aspects of collaborative depression care implementation in local cardiology settings remains unknown. This landmark, quality improvement initiative, embedded within an implementation-science randomised controlled trial (RCT), aims to evaluate whether collaborative depression care improves depression management in coronary heart disease (CHD) populations, with concomitant reductions in depressive symptoms and major adverse cardiac events (MACE).  

This multicentre clinical trial is set within 4 public hospitals in metropolitan Adelaide. Hospitals exposed to the intervention will implement standardised routine depression screening, consisting of the Patient Health Questionnaire-9 (PHQ-9). A multidisciplinary team of investigators will support nurse care managers at each hospital to coordinate collaborative depression care in CHD patients with depressive symptoms (approximately 15-20% of CHD admissions).

Collaborative care consists of ongoing support to the treating cardiologists and primary care physicians with recommendations for initiation of antidepressants and/or cognitive behavioural therapy, supplemented by follow-up at set intervals. The primary outcome for the quality improvement initiative is uptake of collaborative depression care after standardised depression screening (proportion of depressed patients receiving vs. not receiving collaborative care). Secondary outcomes are depression remission (50% reduction in PHQ-9 or total score

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