This paper is a protocol for a systematic review and meta-analysis evaluating collaborative care for comorbid depression and coronary heart disease, and thus contains no clinical results.
Systematic Review
Does collaborative care improve major adverse cardiac events, depression, anxiety, quality of life, and cost-effectiveness in adults with comorbid depression and coronary heart disease?
This protocol outlines a systematic review and meta-analysis to evaluate the effectiveness and cost-effectiveness of collaborative care for depression in populations primarily with coronary heart disease.
BACKGROUND: Depression and coronary heart disease (CHD) are frequently comorbid and portend higher morbidity, mortality and poorer quality of life. Prior systematic reviews of depression treatment randomized controlled trials (RCTs) in the population with CHD have not assessed the efficacy of collaborative care. This systematic review aims to bring together the contemporary research on the effectiveness of collaborative care interventions for depression in comorbid CHD populations. METHODS/DESIGN: Electronic databases (Cochrane Central Register of Controlled Trials MEDLINE, EMBASE, PsycINFO and CINAHL) will be searched using a sensitive search strategy exploding the topics CHD, depression and RCT. Full text inspection and bibliography searching will be conducted, and authors of included studies will be contacted to identify unpublished studies. Eligibility criteria are: population, depression comorbid with CHD; intervention, RCT of collaborative care defined as a coordinated model of care involving multidisciplinary health care providers, including: (a) primary physician and at least one other health professional (e.g. nurse, psychiatrist, psychologist), (b) a structured patient management plan that delivers either pharmacological or non-pharmacological intervention, (c) scheduled patient follow-up and (d) enhanced inter-professional communication between the multiprofessional team; comparison, either usual care, enhanced usual care, wait-list control group or no further treatment; and outcome, major adverse cardiac events (MACE), standardized measure of depression, anxiety, quality of life, cost-effectiveness. Screening, data extraction and risk of bias assessment will be undertaken by two reviewers with disagreements resolved through discussion. Meta-analytic methods will be used to synthesize the data collected relating to the outcomes. DISCUSSION: This review will evaluate the effectiveness and cost-effectiveness of collaborative care for depression in populations primarily with CHD. The results will facilitate integration of evidence-based practice for this precarious population. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42014013653.
Tully et al. (Tue,) conducted a systematic review in Comorbid depression and coronary heart disease. Collaborative care vs. Usual care, enhanced usual care, wait-list control group, or no further treatment was evaluated on All-cause and CHD-related mortality as well as non-fatal MACE. This paper is a protocol for a systematic review and meta-analysis evaluating collaborative care for comorbid depression and coronary heart disease, and thus contains no clinical results.
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