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Prof. Dr. med.  Bernd Löwe, Dipl.-Psych.

Universitätsklinikum Hamburg-Eppendorf

Institut und Poliklinik für Psychosomatische Medizin

Martinistr. 52

20246 Hamburg  

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Improvement in efficiency of depression screening through targeted patient information: Randomised controlled study (DEPSCREEN-INFO)

Aim of investigation

The aim of the investigation is to evaluate the effectiveness of care-based minimal intervention on the course of depressive symptoms in patients with coronary heart disease (CHD). Through targeted and early patient information in the framework of a screening, the extent of depression should be reduced and the proportion of appropriately treated patients increased. The main hypothesis is that state-of-the-art screening plus patient feedback after one month leads to a greater reduction of the depression than state-of-the-art screening without patient feedback.

 

Type of study

Randomised mono-centre observer-blind controlled study

 

Intervention

Control group: State-of-the-art depression screening

Intervention group: State-of-the-art depression screening plus targeted patient information on screening outcome and treatment options

Primary endpoint: Degree of depression 1 month after screening

Secondary endpoint: Proportion of appropriately treated patients with clinically significant depression 1 month after screening, health-economic endpoints

 

Sample

The study is implemented in patients with clinically established CHD, as these show an increased risk of depression, are only rarely treated and a screening is increasingly recommended by professional associations.

 

Inclusion criteria:

 

  1. Presentation in cardiology practice or outpatient clinic due to CHD;
  2. Age ≥ 18 years
  3. Sufficient German language abilities;
  4. Access to a telephone;
  5. Willingness to participate in initial survey and follow-ups,
  6. Informed consent

 

Exclusion criteria:

 

  1. Life-threatening health state;
  2. Severe somatic or mental disorders which require immediate intervention;
  3. Acute suicidal tendency;
  4. Severe cognitive or visual impairment;
  5. Inability to fill out a computerised questionnaire.

 

Sample Size

N (invited to participate) = 3500

N (screening complete) = 2695 (77% participation)

N (positive screening result) = 458 (17% positive screening)

N (complete data 1 month post screening) = 352 (77% participation)

 

Data collection

Intervention study; telephone follow-up data collections after 1 and 6 months

 

Procedure

CHD patients from cardiology practices and outpatient clinics fill in the electronic depression screening questionnaire during the waiting time. To avoid burden to the practice procedure, the handing out of the electronic assessment instruments (tablet PCs) and the informing of the patients ensues through academic assistants /doctoral students. The academic assistants /doctoral students also transfer basic cardiac data of the patients from the medical files (NYHA stage, basic illness etc.). Patients with a positive screening result are contacted by the study workers after a period of 1 and 6 months by telephone and are surveyed regarding symptoms of depression and their treatment. The data from the respective practice / outpatient clinic will be made available to the physicians on a pseudonym basis.

 

Requirements for participation

The participating practices /outpatient clinics will be asked to provide the number of treated CHD patients per year for the planning of case numbers as well as written consent to participate in the study (will be provided by the study leaders).

 

Current status of the project

Beginning of the study: April 2011

Beginning of the recruitment: September 2011




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