A diagnosis of depression in Medicare beneficiaries with recent myocardial infarction was associated with a higher likelihood of attending cardiac rehabilitation (28% vs 9%; OR 3.9, 99% CI 3.7-4.2).
Cohort (n=158,991)
Does a diagnosis of depression reduce cardiac rehabilitation attendance in Medicare beneficiaries with recent myocardial infarction?
Contrary to prior assumptions based on small studies, a diagnosis of depression in Medicare beneficiaries post-MI is associated with significantly higher rates of cardiac rehabilitation enrollment and completion.
Odds Ratio: 3.9 (95% CI 3.7–4.2)
Tasa de eventos absoluta: 28% vs 9%
PURPOSE: On the basis of several small studies, depression is often considered a barrier to cardiac rehabilitation (CR) enrollment and program completion. The purpose of this research was to examine the association between depression diagnosis and participation in CR in a large sample of Medicare beneficiaries with recent myocardial infarction (MI). METHODS: This was a retrospective study of Medicare beneficiaries with an MI during 2008 (N = 158 991). CR enrollment was determined by the Carrier and Outpatient files using the Healthcare Common Procedure Coding System #93797 or #93798. Depression diagnosis was obtained from the International Classification of Diseases, Ninth Revision (ICD-9) codes in the Medicare Provider Analysis and Review (MEDPAR), Outpatient and Carrier Files. The association between depression diagnosis and CR attendance was evaluated using multivariable logistic regression. RESULTS: Overall, 14% (n = 22 735) of the study population attended CR within 1 year of MI diagnosis. Twenty-eight percent (n = 43 827) had a diagnosis of depression, with 96% of cases documented before enrollment in CR. Twenty-eight percent with a diagnosis of depression compared with 9% without depression attended CR. In adjusted analysis, patients with depression were 3.9 (99% CI, 3.7-4.2) times more likely to attend CR compared with those without depression. Program completion (≥25 sessions) was more common in those with depression (56%) than in those without (35%) (P < .001). CONCLUSIONS: Diagnosis of depression in Medicare beneficiaries was strongly associated with attending CR and attending more sessions of CR compared with those without depression. Depression is not a barrier to CR participation after MI in Medicare beneficiaries.
Zullo et al. (Fri,) conducted a cohort in recent myocardial infarction (n=158,991). Depression diagnosis vs. No depression diagnosis was evaluated on Cardiac rehabilitation attendance (OR 3.9, 95% CI 3.7-4.2). A diagnosis of depression in Medicare beneficiaries with recent myocardial infarction was associated with a higher likelihood of attending cardiac rehabilitation (28% vs 9%; OR 3.9, 99% CI 3.7-4.2).