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Collaborative Care and Related Interventions in Patients With Heart Disease: An Update and New Directions.

ABSTRACT: BACKGROUND:Psychiatric disorders, such as depression, are very common in cardiac patients and are independently linked to adverse cardiac outcomes, including mortality. Collaborative care and other integrated care models have been used successfully to manage psychiatric conditions in patients with heart disease, with beneficial effects on function and other outcomes. Novel programs using remote delivery of mental health interventions and promotion of psychological well-being may play an increasingly large role in supporting cardiovascular health. METHODS:We review prior studies of standard and expanded integrated care programs among patients with cardiac disease, examine contemporary intervention delivery methods (e.g., Internet or mobile phone) that could be adapted for these programs, and outline mental health-related interventions to promote healthy behaviors and overall recovery across all cardiac patients. RESULTS:Standard integrated care models for mental health disorders are effective at improving mood, anxiety, and function in patients with heart disease. Novel, "blended" collaborative care models may have even greater promise in improving cardiac outcomes, and interfacing with cardiac patients via mobile applications, text messages, and video visits may provide additional benefit. A variety of newer interventions using stress management, mindfulness, or positive psychology have shown promising effects on mental health, health behaviors, and overall cardiac outcomes. CONCLUSIONS:Further study of novel applications of collaborative care and related interventions is warranted given the potential of these programs to increase the reach and effect of mental health interventions in patients with heart disease.

SUBMITTER: Huffman JC

PROVIDER: S-EPMC5748007 | biostudies-other | 2018 Jan - Feb

REPOSITORIES: biostudies-other

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Collaborative Care and Related Interventions in Patients With Heart Disease: An Update and New Directions.

Huffman Jeff C JC Adams Caitlin N CN Celano Christopher M CM

Psychosomatics 20170918 1

<h4>Background</h4>Psychiatric disorders, such as depression, are very common in cardiac patients and are independently linked to adverse cardiac outcomes, including mortality. Collaborative care and other integrated care models have been used successfully to manage psychiatric conditions in patients with heart disease, with beneficial effects on function and other outcomes. Novel programs using remote delivery of mental health interventions and promotion of psychological well-being may play an ...[more]

PMID: 29078987

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Project description:BackgroundCollaborative care involves active engagement of primary care and hospital physicians in shared care of patients beyond usual discharge summaries. This enhances community-based care and reduces dependence on specialists and hospitals. The model, successfully implemented in chronic care management, may have utility for treatment of depression in cancer. The aim of this systematic review was to identify components, delivery and roles and responsibilities within collaborative interventions for depression in the context of cancer.MethodsMedline, PsycINFO, CINAHL, Embase, Cochrane Library and Central Register for Controlled Trials databases were searched to identify studies of randomised controlled trials comparing a treatment intervention that met the definition of collaborative model of depression care with usual care or other control condition. Studies of adult cancer patients with major depression or a non-bipolar depressive disorder published in English between 2005 and January 2018 were included. Cochrane checklist for risk of bias was completed (Study Prospero registration: CRD42018086515).ResultsOf 8 studies identified, none adhered to the definition of 'collaborative care'. Interventions delivered were multi-disciplinary, with care co-ordinated by nurses (n?=?5) or social workers (n?=?2) under the direction of psychiatrists (n?=?7). Care was primarily delivered in cancer centres (n?=?5). Care co-ordinators advised primary care physicians (GPs) of medication changes (n?=?3) but few studies (n?=?2) actively involved GPs in medication prescribing and management.ConclusionsThis review highlighted joint participation of GPs and specialist care physicians in collaborative care depression management is promoted but not achieved in cancer care. Current models reflect hospital-based multi-disciplinary models of care.Protocol registrationThe protocol for this systematic review has been registered with PROSPERO. The registration number is CRD42018086515.

Dataset Information

Collaborative Care and Related Interventions in Patients With Heart Disease: An Update and New Directions.

Publications

Collaborative Care and Related Interventions in Patients With Heart Disease: An Update and New Directions.

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