Telephone-delivered collaborative care for post-CABG depression is more effective than usual care for improving quality of life related to mental health.

摘要

Rollman and colleagues studied an intervention designed to manage depression following coronary artery bypass graft (CABG) surgery, a common and debilitating condition during recovery. Although other individual interventions have been tested, including antidepressant medication and individual counselling, few have been shown to improve depression. The intervention here, which the authors label 'Bypassing the Blues', is unique in that it uses a collaborative care model, managed and delivered by a nurse. Nurses deliver the intervention by telephone, and although there is a protocol, cases may be individualised during weekly reviews with a psychiatrist. Patients are recommended various treatments that foster self-management, including a workbook. Initiation and alteration of antidepressant medications and referral to specialist support are undertaken in consultation with patients' primary care physician. The PHQ-9 is used to monitor participants' depression from week 2, with telephone calls every other week during the acute phase, reducing to every 1-2 months until 8 months of treatment was reached.