Key result
Depression is highly prevalent, affecting 51.5% of people with heart failure in low- and middle-income countries, and is significantly associated with poorer health-related quality of life.
Why the study?
Heart failure is a growing global health concern with high symptom burden like depression affecting quality of life, but pooled prevalence and its link to HRQoL in LMICs were not established.
Systematic Review (n=5,074)
Effect estimate: Prevalence 51.5% (95% CI 39.7-63.3)
Almost half of all patients with heart failure in low- and middle-income countries have comorbid depression, which is significantly associated with poor health-related quality of life, highlighting the critical need for early screening.
Depression screening may warrant consideration in LMIC heart failure care; leaves open causal impact and intervention trials.
INTRODUCTION: Heart failure is a growing public health concern around the world. People with heart failure have a high symptom burden, such as depression, which affects health-related quality of life (HRQoL). The objective of this systematic review and meta-analysis was to estimate the pooled prevalence of depression and evaluate its association with HRQoL among people with heart failure in low- and middle-income countries (LMICs). METHODS: This systematic review was conducted in accordance with the JBI methodology. Electronic databases such as MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, Scopus and JBI EBP were searched to identify relevant studies published from January 2012 to August 2022. The methodological quality of each article was assessed using relevant JBI critical appraisal instruments. A random-effects model was employed to estimate the pooled prevalence of depression. Heterogeneity across the studies was investigated using Cochrane's Q test and I2 statistic. The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines 2020 were followed for reporting the results. All statistical analyses were performed using STATA version 17 software. RESULTS: After screening, a total of 21 eligible articles with 5074 participants with heart failure were included in this review. The pooled prevalence of depression among people with heart failure in LMICs was 51.5% (95% CI = 39.7, 63.3%, I2 = 99.00%). Subgroup analysis revealed, the highest prevalence in studies whose participants were in-patients, and from the Middle East and North Africa, and studies utilizing Becks Depression Inventory (BDI). Depression was positively associated with HRQoL. CONCLUSION: This review revealed that almost half of all people with heart failure in low- and middle-income countries have comorbid depression. People with heart failure and depressive symptoms had poor HRQoL. Therefore, early screening of depression is critical for improving HRQoL in this population. Systematic review registration: PROSPERO CRD42022361759.
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Mulugeta et al. (2023) conducted a systematic review in Heart failure (n=5,074). Depression vs. No depression was evaluated on Prevalence of depression (Prevalence 51.5%, 95% CI 39.7-63.3). Depression is highly prevalent, affecting 51.5% of people with heart failure in low- and middle-income countries, and is significantly associated with poorer health-related quality of life.
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