Abstract 14033: Assessment of Psychology Services Partnered With Clinical Care to Improve Cardiovascular Risk Factor Control

Abstract

Introduction: Psychological distress greatly impacts cardiovascular disease, and targeted efforts to improve access to psychological services in cardiology care may aid in the reducing of cardiovascular risk factors. The objective of this preliminary study was to assess the impact and characterize the need for and use of short-term psychotherapy in cardiology by partnering a supervised postdoctoral psychology fellow with our cardiovascular prevention and women’s heart programs. Methods: A retrospective chart review was performed from January 2019 to June 2022. Participants included 36 patients engaged in preventive cardiology who attended at least one therapy session (mean age=57.6 years; 72% female; 19.4% Black, 8.3% Hispanic, 47.2% White, 24.9% other ethnicity). If available, hemoglobin A1C, LDL, weight, BMI, and blood pressure were recorded within six months pre- and post-therapy. Results: Mental health diagnoses included MDD (22.2%), GAD (47.2%) and adjustment disorder (25%). Comorbidities included HLD (69.4%), HTN (66.6%), CAD (41.6%) and DM (16.6%). 17 patients were former smokers, and one was a current smoker. More than half (52.8%) attended ≥6 psychotherapy sessions, 38.9% attended ≥6 preventive cardiology visits and 2.7% attended a nutritionist visit in the same time frame. In patients with HTN with both pre- and post-therapy measurements (n=24), 50% were above goal (130/80) pre-therapy and 20.8% post. Regarding weight (n=27), 48.2% lost weight. Among patients with LDL≥100 pre-therapy (n=9), 55.5% achieved LDL <100 post-therapy. Among patients with an A1C≥5.7 pre-therapy (n=8), 12.5% lowered their A1C to <5.7. Conclusions: Although further studies are needed to assess the benefit of each component of care, our preliminary study shows the demand for and potential benefit from psychological services when delivered concurrently with preventive cardiology visits. There was a high level of engagement, with over half of patients attending six or more therapy sessions. Marked improvement in blood pressure, LDL, and weight were noted. These preliminary findings raise the possibility that expanding access to psychological services in clinical cardiology care may be a model to reduce excess cardiovascular risk.