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Clinical outcomes associated with screening and referral for depression in an acute cardiac ward.

Abstract

AIM

The aim of this paper is to describe the implementation of a depression screening and referral tool in two cardiac wards of a major metropolitan public hospital. The tool consisted of two sections: (1) screening for depression risk (Cardiac Depression Scale-5) and (2) consequential referral actions.

BACKGROUND

Prior research has shown that depression in patients with heart disease is associated with significantly impaired quality of life, decreased medication adherence, increased morbidity and increased use of healthcare services.

DESIGN

A prospective in-patient study design.

METHOD

A consecutive sample of 202 patients admitted to either the cardiac medical (n = 145) or surgical (n = 57) wards of a major Melbourne metropolitan hospital were recruited into the study over an 18-week period.

RESULTS

Just over half (54%) of the patients were identified as 'at risk' of depression. Of these, 19% were assessed as moderate risk and 35% high risk. Of those patients, 91% had the risk score documented in their medical history, 90% had engaged in discussions with clinicians regarding their risk score, 85% had their risk score communicated formally to the medical team and 25% were formally referred for appropriate follow-up - significantly more than prior to implementation of the screening and referral tool.

CONCLUSIONS

By providing a formalised mechanism for detecting depression, documented screening and referral rates improved for those with comorbid depression and heart disease affording an opportunity for early intervention. These findings support a move towards integrated approaches to screening of depression to become standard practice in the acute cardiac setting.

RELEVANCE TO CLINICAL PRACTICE

Such mechanisms also have the potential to initiate the development of new models of care that acknowledge the complexity of comorbid depression and heart disease and provide pathways from speciality to primary care which integrate the physical and psychosocial domains inclusive of screening, referral, systematic monitoring and streamlined behavioural and physical care.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Cardiovascular Research Centre, Australian Catholic University, Melbourne, Vic., Australia. chantal.ski@acu.edu.au

    , , , ,

    Source

    Journal of clinical nursing 21:15-16 2012 Aug pg 2228-34

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Cardiology Service, Hospital
    Depression
    Female
    Hospital Departments
    Hospitalization
    Humans
    Male
    Mass Screening
    Middle Aged
    Myocardial Infarction
    Outcome Assessment (Health Care)
    Prospective Studies
    Referral and Consultation
    Victoria

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22268823

    Citation

    Ski, Chantal F., et al. "Clinical Outcomes Associated With Screening and Referral for Depression in an Acute Cardiac Ward." Journal of Clinical Nursing, vol. 21, no. 15-16, 2012, pp. 2228-34.
    Ski CF, Page K, Thompson DR, et al. Clinical outcomes associated with screening and referral for depression in an acute cardiac ward. J Clin Nurs. 2012;21(15-16):2228-34.
    Ski, C. F., Page, K., Thompson, D. R., Cummins, R. A., Salzberg, M., & Worrall-Carter, L. (2012). Clinical outcomes associated with screening and referral for depression in an acute cardiac ward. Journal of Clinical Nursing, 21(15-16), pp. 2228-34. doi:10.1111/j.1365-2702.2011.03934.x.
    Ski CF, et al. Clinical Outcomes Associated With Screening and Referral for Depression in an Acute Cardiac Ward. J Clin Nurs. 2012;21(15-16):2228-34. PubMed PMID: 22268823.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Clinical outcomes associated with screening and referral for depression in an acute cardiac ward. AU - Ski,Chantal F, AU - Page,Karen, AU - Thompson,David R, AU - Cummins,Robert A, AU - Salzberg,Mike, AU - Worrall-Carter,Linda, Y1 - 2012/01/23/ PY - 2012/1/25/entrez PY - 2012/1/25/pubmed PY - 2012/12/10/medline SP - 2228 EP - 34 JF - Journal of clinical nursing JO - J Clin Nurs VL - 21 IS - 15-16 N2 - AIM: The aim of this paper is to describe the implementation of a depression screening and referral tool in two cardiac wards of a major metropolitan public hospital. The tool consisted of two sections: (1) screening for depression risk (Cardiac Depression Scale-5) and (2) consequential referral actions. BACKGROUND: Prior research has shown that depression in patients with heart disease is associated with significantly impaired quality of life, decreased medication adherence, increased morbidity and increased use of healthcare services. DESIGN: A prospective in-patient study design. METHOD: A consecutive sample of 202 patients admitted to either the cardiac medical (n = 145) or surgical (n = 57) wards of a major Melbourne metropolitan hospital were recruited into the study over an 18-week period. RESULTS: Just over half (54%) of the patients were identified as 'at risk' of depression. Of these, 19% were assessed as moderate risk and 35% high risk. Of those patients, 91% had the risk score documented in their medical history, 90% had engaged in discussions with clinicians regarding their risk score, 85% had their risk score communicated formally to the medical team and 25% were formally referred for appropriate follow-up - significantly more than prior to implementation of the screening and referral tool. CONCLUSIONS: By providing a formalised mechanism for detecting depression, documented screening and referral rates improved for those with comorbid depression and heart disease affording an opportunity for early intervention. These findings support a move towards integrated approaches to screening of depression to become standard practice in the acute cardiac setting. RELEVANCE TO CLINICAL PRACTICE: Such mechanisms also have the potential to initiate the development of new models of care that acknowledge the complexity of comorbid depression and heart disease and provide pathways from speciality to primary care which integrate the physical and psychosocial domains inclusive of screening, referral, systematic monitoring and streamlined behavioural and physical care. SN - 1365-2702 UR - https://www.unboundmedicine.com/medline/citation/22268823/Clinical_outcomes_associated_with_screening_and_referral_for_depression_in_an_acute_cardiac_ward_ L2 - https://doi.org/10.1111/j.1365-2702.2011.03934.x DB - PRIME DP - Unbound Medicine ER -