The Management of Patients with Heart Failure and Depression: a Systematic Review
Background: Heart failure (HF) is a chronic and incapacitant disease with bad prognosis, and it is commonly related to psychosocial comorbidities that difficult treatment adhesion. The prevalence of depression in HF varies from 20 to 40%, occurring 3 to 5 times more frequently in patients with HF than general population. The coexistence of depressive symptoms depreciates heart condition in patients with HF: depressive symptoms predict mortality, re-hospitalization, and an augment of symptoms in those patients. Aiming to clarify certain aspects of this comorbidity, it was performed a systematic review using Scopus and MEDLINE/PubMed databases, correlating HF and depression, from January 1, 2013, to August 20, 2017, by means of the descriptors found in MeSH: “heart failure” and "depression".
Methods:Data screening applied combinations, as follows: #1. “Heart Failure” [MeSH Terms]; #2. “Depression” [MeSH Terms]; #3. “Management” [Keyword], using the following research strategy: (#1 AND #2) AND #3.
Results:Improvement in depression levels through interventions using telephone is extensively reported in literature, based on providing information about the disease, self-care accompaniment, or cognitive behavioral therapy (CBT). Because of this, it is shown as an effective alternative in depression, improving surviving rates. Equally effective interventions were the empowering of the patient and the familial engagement in caring, palliative care and multidisciplinary participation in construction of caring program.
Conclusions: Curiously, physical exercises did not show, statistically, efficiency in depression improvement, and few were the articles approaching antidepressant medications use in this class of patient.
Lundgren, J., A, G., D, O., J, T., K, A. K., & J, P. (2015). Internet-based cognitive behavior therapy for patients with heart failure and depressive symptoms: a proof of concept study. Patient Education Counseling, 98(8), 935-942. From https://doi.org/10.1016/j.pec.2015.04.013
Jaarsma, T., H, R., T, F., A, H. H., D, K., & D, J. (2000). Self-care and quality of life in patients with advanced heart failure: the effect of a supportive educational intervention. Heart & Lung 29(5), 319-330. From https://doi.org/10.1067/mhl.2000.108323
Cockayne, S., P, J., W, G., R, G., & L, R. (2014). Nurse facilitated Self-management support for people with heart failure and their family carers (SEMAPHFOR): a randomised controlled trial. Internationla Journal of Nursing Studies, 51(9), 1207-1213. From https://doi.org/10.1016/j.ijnurstu.2014.01.010
Bekelma, D. B., P, M. E., S, M. D., N, K., H, B., M, C., L, K. G., P, J., H, P., & R, J. S. (2013). Patient-centered disease management (PCDM) for heart failure: Study protocol for a randomised controlled trial. BMC Cardiovascular Disorders, 13(49), 1-6. From https://doi.org/10.1186/1471-2261-13-49
Bekelma, D. B. H, S., N, C. T., M, D. S., M, P., M, C., H, B., L, K. A., & H, P. A. (2014). Feasibility and Acceptability of a Collaborative Care Intervention To Improve Symptoms and Quality of Life in Chronic Heart Failure: Mixed Methods Pilot Trial. Journal of Palliative Medicine, 17(2), 145-151. From https://doi.org/10.1089/jpm.2013.0143
Greene, S., F, G. C., V, M., K, S. S, B, J., & G, M. (2015). The vulnerable phase after hospitalization for heart failure. Nature Reviews. Cardiology, 12(4), 220-229. From https://doi.org/10.1038/nrcardio.2015.14
Tisminetzky, M., M, D., E, N., S, J. S., Y, J., G, E., G, J., & G, R. (2015). Thirty day hospital re-admissions in patients with non ST-segment elevation acute myocardial infarction. The American Journal of Medicine, 128(7), 760-765. From https://doi.org/10.1016/j.amjmed.2015.01.022
Kemper, K. J., C, C., M, B., & B, P. (2016). Integrative Medical Care Plus Mindfulness Training for Patients With Congestive Heart Failure. Journal of Evidence-based. Complementary & Alternative Medicine, 21(4), 282-290. from https://doi.org/10.1177/2156587215599470
McMurray, J. J. A, S., A, S. D., A, A., B, M., D, K., F, V., F, G., F, C., G, M. A., J, T., K, L., L, G. Y., M, A. P., P, A., P, B. M., P, B. A., R, P. K., R, F. H., S, J., S, P., S, J., T, P. T., V, A. A., Z, F., & Z, A. (2012). ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2012. European Journal of Heart Failure, 14(8), 803-869. From https://doi.org/10.1093/eurjhf/hfs105
Tully, P. J., S, T., B, J., & R, C. (2015). A dynamic view of comorbid depression and generalized anxiety disorder symptom change in chronic heart failure: the discrete effects of cognitive behavioral therapy, exercise, and psychotropic medication. Disability and Rehabilitation, 37(7), 585-592. From https://doi.org/10.3109/09638288.2014.935493
Bleumink, G., K, A. M., S, M. C., S, S. M., H, A., D, J. W., W, J. C., & S, B. H. (2004). Quantifying the heart failure epidemic: prevalence, incidence rate, lifetime risk and prognosis of heart failure. European Heart Journal, 25(18), 1614-1619. From https://doi.org/10.1016/j.ehj.2004.06.038
Juenger, J., S, D., K, S., H, A., Z, C., H, W., & H, M. (2002). Health related quality of life in patients with congestive heart failure: comparison with other chronic diseases and relation to functional variables. Heart, 87(3), 235-241. From https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1767036/pdf/hrt08700235.pdf
Lossnitzer, N., H, W., S, J. H., T, T., F, L., & W, B. (2015). A patient-centered perspective of treating depressive symptoms in chronic heart failure: what do patients prefer? Patient Education and Counseling, 98(6), 783-787. From https://doi.org/10.1016/j.pec.2015.02.008
Adams, K., F, G. C., E, C. L., L, T. H., C, M. R., A, W. T., B, R. L., G, M., & H, D. P. (2005). Characteristics and outcomes of patients hospitalized for heart failure in the United States: rationale, design, and preliminary observations from the first 100,000 cases in the Acute Decompensated Heart Failure National Registry (ADHERE). American Heart Journal, 149(2), 209-216. From https://doi.org/10.1016/j.ahj.2004.08.005
Chamberlain, A. M., S, J. L., G, Y., M, S. M., B, C. M., D, S. M., R, W. A., F, L J., J, R., W, S. A., & R, V. L,. (2015). Multimorbidity in heart failure: a community perspective. The American Journal of Medicine, 128(1), 38-45. From https://doi.org/10.1016/j.amjmed.2014.08.024
Johansson, P., D, U., & B, A. (2006). The measurement and prevalence of depression in patients with chronic heart failure. Progress in Cardiovascular Nursong, 21(1), 28-36. From https://doi.org/10.1111/j.0197-3118.2006.04644.x
Rutledge, T., R, V., L, S., G, B. & M, P. (2006). Depression in heart failure. A meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. Journal the American College of Cardiology, 48(8), 1527-1537. From https://doi.org/10.1016/j.jacc.2006.06.055
Ayuso-Mateos, J., V, J. L., D, C., L, V., D, O. S., C, P., W, C., L, L., P, H., D, G., & W, G. (2001). Depressive disorders in Europe: prevalence figures from the ODIN study. The British Journal of Psychiatry, 179(4), 308-316. From https://doi.org/10.1192/bjp.179.4.308
Parissis, J., F,, K., P, I., & K, D. (2005). Depression in chronic heart failure: novel pathophysiological mechanisms and therapeutic approaches. Expert Opinion on Investigational Drugs, 14(5), 567-577. Fom https://doi.org/10.1517/13543718.104.22.1687
Angermann, C., G, G., S, S., S, M., D, J., E, G., & F, H. (2011). Somatic correlates of comorbid major depression in patients with systolic heart failure. International Journal of Cardiology, 147(1), 66-73. From https://doi.org/10.1016/j.ijcard.2009.07.044
Gelbrich, G., S, S., K, S., F, H., P, C., H, P. U., E, G., & A, C. E. (2014). Effects of structured heart failure disease management on mortality and morbidity depend on patients’ mood: Results from the Interdisciplinary Network for Heart Failure Study. European Journal of Heart Failure, 16(10), 1133-1141. From https://doi.org/10.1002/ejhf.150
Jünger, J., S, D., M, T., R, G., Z, C., H, A., Z, S., H, W., & H, M. (2005). Depression increasingly predicts mortality in the course of congestive heart failure. European Journal of Heart Failure, 7(2), 261-267. From https://doi.org/10.1016/j.ejheart.2004.05.011
Jiang, W., A, J., C, E., K, M., G, L. H., C, M. S., B, M. A., D, C., C, R. M., K, R. R., & O, C. M. (2001). Relationship of depression to increased risk of mortality and rehospi- talization in patients with congestive heart failure. Archives of Internal Medicine, 161(15), 1849-1856. From https://doi.org/10.1001/archinte.161.15.1849
Huffman, J. C., M, C. A., B, S. R., C, C. M., D, C. M., H, B. C., S, L., R, B. L., & J, J. L. (2014). Collaborative care for depression and anxiety disorders in patients with recent cardiac events: the management of sadness and anxiety in cardiology (MOSAIC) randomized clinical trial. JAMA Internal Medicine, 174(6), 927-935. From https://doi.org/10.1001/jamainternmed.2014.739
Bekelman, D. B., P, M. E., C, E. P., S, M. D., N, K. M., H, B., M, C. F., L, K. G., G, K., H, P. A., & R, J. S. (2015). Primary results of the Patient-Centered Disease Management (PCDM) for heart failure study: a randomized clinical trial. JAMA Internal Medicine, 175(5), 725-732. From https://doi.org/10.1001/jamainternmed.2015.0315
Thombs, B., D, P., C, J. C., W, M. A., F, N., M, A. J., Z, M., E, C., L, B. B., S, C. G., S, K., & Z, R. C. (2008). Depression screening and patient outcomes in cardiovascular care: a systematic review. JAMA, 300(18), 2161-2171. From https://doi.org/10.1001/jama.2008.667
Woltz, P. C., C, D. W., F, E., S, H., A, B., & T, S. A. (2012). Effects of interventions on depression in heart failure: a systematic review. Heart & Lung: The Journal of Acute and Critical Care, 41(5), 469-483. From https://doi.org/10.1016/j.hrtlng.2012.06.002
Dekker, R. L. (2011). Cognitive therapy for depression in patients with heart failure: a critical review. Heart Failure Clinics, 7(1), 127-141. From https://dx.doi.org/10.1016%2Fj.hfc.2010.10.001
Gary, R. A., G., D, S. B., H, M. K., M, D. L., & S, A. L. (2010). Combined exercise and cognitive behavioral therapy improves outcomes in patients with heart failure. Journal of Psychosomatic Research, 69(2), 119-131. From https://doi.org/10.1016/j.jpsychores.2010.01.013
Sullivan, M. J., W, L., T, J., B, J., C, A., M, V., J, D., K, M. W., R, B., B, H. B., A, K., & C, M. S. (2009). The support, education, and research in chronic heart failure study (SEARCH): a mindfulnessbased psycheducational intervention improves depression and clinical symptoms in patients with chronic heart failure. American Heart Journal, 157(1), 84-90. From https://doi.org/10.1016/j.ahj.2008.08.033
Dekker, R. L., M, D.K., P, A. R., & L, T. A. (2012). Cognitive therapy improves threemonth outcomes in hospiltalized patients with heart failure. Journal of Cardiac Failure, 18(1), 10-20. From https://dx.doi.org/10.1016%2Fj.cardfail.2011.09.008
Kalter-Leibovici, O., F, D., F, L. S., K, G., Z, A., M, H., B, M., S, B. G., F, N., C, T., A, E., G, A., G, D., A, M., M, S., S, M., & S, H. (2017). Disease management in the treatment of patients with chronic heart failure who have universal access to health care: a randomized controlled trial. BMC Medicine, 15(90), 1-13. From https://doi.org/10.1186/s12916-017-0855-z
Piette, J., D. S, D., M, N., C, J., T, R. B., A, D. C., F, L., & A, J. E. (2015). A mobile health intervention supporting heart failure patients and their informal caregivers: A randomized comparative effectiveness trial. Journal of Medical Internet Research, 17(6), e142 . From https://dx.doi.org/10.2196%2Fjmir.4550
Kenealy, T. W., P, M. J. G., R, A. P. B., D, R. N., S, N. F., H, J. K. H., M, S. C., & R, H. H. (2015). Telecare for diabetes, CHF or COPD: Effect on quality of life, hospital use and costs. A randomised controlled trial and qualitative evaluation. PLoS One, 10(3), 1-21. From https://dx.doi.org/10.1371%2Fjournal.pone.0116188
Duncan, K., P, B., H, M. & N, J. F. (2014). Psychological responses and adherence to exercise in heart failure. Rehabilitation Nursing, 39(3), 130-139. From https://doi.org/10.1002/rnj.106
Evangelista, L. S., L, S., M, M., D, N., B, J., & L, D. (2014). Does the Type and Frequency of Palliative Care Services Received by Patients with Advanced Heart Failure Impact Symptom Burden? Journal of Palliative Medicine, 17(1), 75-79. From https://dx.doi.org/10.1089%2Fjpm.2013.0231
Villani, A., M, G., C, A., D, R. F., B, L., B, G., M, E., & P, G. (2014). Clinical and psychological telemonitoring and telecare of high risk heart failure patients. Journal of Telemedicine and Telecare, 20(8), 468-475. From https://doi.org/10.1177/1357633X14555644
Chung, H., K, A., N, C. J., C, J., R, S, O, M. A., R, D. (2013). Early experience of a pilot intervention for patients with depression and chronic medical illness in an urban ACO. General Hospital Psychiatry, 35(5), 468-471. From https://doi.org/10.1016/j.genhosppsych.2013.04.014
Bandura, A. (1997). Self-efficacy: the exercise of control. New York: W.H. Freeman.
O’Connor, C., J, W., K, M., S, S. G., C, M. S., C, D. D., Z, B., S, W. G., A, R. M, R, S. K., & K, R. (2010). Safety and efficacy of sertraline for depression in patients with heart failure. Journal of the American College of Cardiology, 56(9), 692-699. From https://doi.org/10.1016/j.jacc.2010.03.068
Angermann, C., G, G., S, S., F, A., D, J., F, H., & E, G. (2007). Rationale and design of a randomised, controlled, multicenter trial investigating the effects of selective serotonin re-uptake inhibition on morbidity, mortality and mood in depressed heart failure patients (MOOD-HF). European Journal of Heart Failure, 9(12), 1212-1222. From https://doi.org/10.1016/j.ejheart.2007.10.005
Tousoulis, D., A, A. S., A, C., S, C., S, E., S, G., S, P., P, A., K, P., & S, C. (2010). Role of depression in heart failure—choosing the right antidepressive treatment. International Journal of Cardiology, 140(1), 12-8. From https://doi.org/10.1016/j.ijcard.2009.05.022
Du, H. Y., N, P.J., Z, R., D, R., S, Y., E, B., C, D. C., M, P. S., & D, P. M. (2011). An intervention to promote physical activity and self-management in people with stable chronic heart failure The Home-Heart-Walk study: study protocol for a randomized controlled trial. Trials, 12(63), 1-6. From https://doi.org/10.1186/1745-6215-12-63
Gottlieb, S., K, W. J., T, S. A., K, S., V, M. R., G, N., M, J., C, M., & M, S. (2007). A double-blind placebo-controlled pilot study of controlled-release paroxetine on depression and quality of life in chronic heart failure. American Heart Journal, 153(5), 868-873. From https://doi.org/10.1016/j.ahj.2007.02.024
Lesperánce, F., F, N., L, M. A., W, M., L, S., C, A., T, M., & R, J. L. (2003). An open-label study of nefazodone treatment of major depression in patients with congestive heart failure. The Canadian Journal of Psychiatry, 48(10), 695-701. From https://doi.org/10.1177/070674370304801009
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