Prevalent depression in patients with chronic heart disease: Baseline profile of the TAKE-HEART in primary care study cohort

Background: Although there is a strong and consistent association between depression and chronic heart disease (CHD) the value of screening for depression in patients with CHD in primary care is unknown. Methods: The TAKE-HEART Study is a cluster randomised trial in 19 SA general practices designed to determine if a program of screening for depression, academic detailing and tailored psychiatric advice to support GPs can reduce co-morbid depression in patients with CHD, relative to usual care during 12 month follow-up. Depression was detected via the Centre for Epidemiological Studies Depression scale; ≥16 indicated mild depression and ≥27 moderate–severe depression. Results: 284 participants (mean age 70 ± 10 years, 65% male) were enrolled in the study. The most common form of CHD was coronary artery disease (78%) with 44% of patients being treated with chronic angina pectoris and 34% with a prior history of acute myocardial infarction. A further 38% and 20% were being treated for atrial fibrillation and heart failure, respectively. The baseline prevalence of depression was 27.1% (19.4% mild and 7.7% moderate to severe), a rate significantly higher than that observed in the general SA population (17%, OR 1.81, 95% confidence interval [CI] CI: 1.36–2.42, p = <0.0001). A non-significant, but higher proportion of women than men experienced depression (31.3% vs. 24.9%, OR 1.38, 95% CI: 0.77–2.45%; p = 0.2). Conclusion: These data confirm high levels of depression in patients being treated for CHD in primary care and the potential value of the TAKE-HEART intervention.Kerena Eckert, Geoffrey Schrader, David Wilkinson, Deborah Askew, Marie-Louise Dick, Tony Wade, Thomas Marwick, Paul Scuffham, Claire Jackson, Philip Schluter, Robert Goldney, Else Jansen, Tania Stewart and Simon Stewar