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Clinical outcomes associated with screening and referral for depression in an acute cardiac ward.
J Clin Nurs 2012; 21(15-16):2228-34JC

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.

Authors+Show Affiliations

Cardiovascular Research Centre, Australian Catholic University, Melbourne, Vic., Australia. chantal.ski@acu.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

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 -