The importance of screening for depression and anxiety in ambulatory patients with chronic heart failure and the role of health care professionals

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Depression and anxiety are very common in patients with heart failure, both as risk factors and complications. The intensive follow-up by health care specialist is extremely important for screening of these conditions and for reducing their impact on the heart failure (HF) course. Aim to screen for depression and anxiety attitudes and to assess the effect of structured out-patient program for reducing the probability of their occurrence. Participants and methods: Overall, 71 patients were included in a structured follow-up program for ambulatory management of patients with HF, according to the OPTIMIZE-HF Care Program protocol. All participants answered standardized questionnaires PHQ-9 and GAD-7 for screening of depression and anxiety at discharge from hospital (baseline) and after 6 months. Score more than 8 points for GAD-7 and >10 points of PHQ-9 were considered clinically important. Paired samples t-test and Wilcoxon’s signed rank test were used to test statistical significance. Results the mean depression score decreased from mean 5.47±5,22 points to 3.65±6.05, with a mean difference between two visits 2.35±3.9, 95%CI 1.37-3.33, р<0.0001. At 6 months, the participants with PHQ-9>10 points decreased from 21% to 7.8% (Figure 1). There were 8 (14%) patients who were more prone to depression at baseline but who decreased their score to <10 points at the end (p = 0.04). Similar results were found for anxiety. The mean difference in GAD-7 score was -2.35±3.90 points, 95%CI -1.37—-3.33, p<0;0001. At the end of the study, the participants without anxious moods increased from 52.3% to 69.8%. (Figure 1) Only 3 patients worsened their anxiety results after 6 months while 27% of those with initial GAD-7>8 points successfully decreased their score to minimal or none. Conclusions Every 1 in 5 patients with HF have some depression attitudes at discharge and more than 1 in 3 were anxious. The structured ambulatory management program decreased these trends just after 6 months. The role of nurse in achieving the positive effects on the psychological well-being of the patients with HF is essential.Figure 1