Key result
Intensive cardiac rehabilitation is linked to up to a ~6-point reduction in PHQ-9 depression scores.
Why the study?
The impact of outpatient Intensive Cardiac Rehabilitation on depression and cardiac self-efficacy among patients with qualifying cardiac diagnoses was not well established.
Does outpatient Intensive Cardiac Rehabilitation improve depression and cardiac self-efficacy in patients with a qualifying cardiac diagnosis?
Cohort (n=268)
No
Does outpatient Intensive Cardiac Rehabilitation improve depression and cardiac self-efficacy in patients with a qualifying cardiac diagnosis?
p-value: p=< 0.0001
Outpatient Intensive Cardiac Rehabilitation is associated with significant improvements in depressive symptoms and cardiac self-efficacy, particularly in patients with baseline depression.
ICR participation was associated with fewer depressive symptoms and higher self-efficacy; hypothesis-generating and needs randomized confirmation before practice change.
Study objective: To evaluate whether an Intensive Cardiac Rehabilitation (ICR) program improves depression and cardiac self-efficacy among patients with a qualifying cardiac diagnosis. Design: Prospective, longitudinal cohort design. Setting: Single-center, tertiary referral, outpatient cardiac rehabilitation center. Participants: Patients with a qualifying diagnosis for ICR. Interventions: Outpatient ICR. Main outcome measures: Mental health, as assessed using the Patient Health Questionnaire-9 (PHQ-9) and cardiac self-efficacy using the Cardiac Self-Efficacy (CSE) scale. Results: Of the 268 patients included (median age 69 y, 73% men), 70% had no depressive symptoms at baseline (PHQ-9 score <5). PHQ-9 scores improved in the overall sample (p < 0.0001), with greater improvements among patients with mild depressive symptoms at baseline (-4 points, p < 0.001) and those with moderate to severe depressive symptoms at baseline (-5.5 points, p < 0.001). Cardiac self-efficacy improved overall, and the two subsections of the cardiac self-efficacy questionnaire titled, "maintain function" and "control symptoms" improved (all p < 0.001). Conclusions: Participation in an outpatient ICR program is associated with fewer depressive symptoms and greater cardiac self-efficacy among patients with CVD who qualify for ICR. The improvement in depression was greatest for those with moderate to severe depressive symptoms.
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McKenzie et al. (2022) conducted a cohort in Cardiovascular disease (n=268). Outpatient Intensive Cardiac Rehabilitation (ICR) was evaluated on Mental health (PHQ-9) and cardiac self-efficacy (CSE scale) (p=< 0.0001). Outpatient Intensive Cardiac Rehabilitation significantly improved overall depression scores (P<0.0001), with up to a 5.5-point reduction in those with moderate-to-severe symptoms.
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