BACKGROUND: The Patient Health Questionnaire 9 (PHQ-9) is an effective tool for identification and grading of depression symptoms. Data on PHQ-9 utility for patients with heart failure (HF) are limited. METHODS: We evaluated the severity of depression by PHQ-9 at baseline and its association with health care resource utilization (HCRU) rates and quality of life (QoL) in 308 outpatients enrolled in a prospective HF cohort study. Depression symptoms were stratified according to PHQ-9 score as minimal (0-4), mild (5-9), or moderate-to-severe (10-27). RESULTS: Mean age of patients was 57±11years; 65% were men; 50% were white and 47% black; ejection fraction was 30±15%. Over 24±12months (total: 625person-years), there were 41 (13.3%) major clinical events (34 deaths, 5 transplants, 2 ventricular assist device implantations), 633 all-cause admissions (249 [39.3%] for HF), and 362 emergency department (ED) visits. Moderate-to-severe depressive symptoms were associated with 70% more all-cause admissions compared to patients without depressive symptoms and 2.5 times more HF-related admissions. However, less than 50% of patients with moderate-to-severe symptoms were on antidepressants. In adjusted analyses, even mild depressive symptoms were associated with 57% more all-cause admissions compared to patients without depressive symptoms and more than 2-fold higher rate of HF-related admissions. Depressive symptoms were not associated with ED visits. Increasing PHQ-9 score was associated with progressively worse QoL. PHQ-9 was not associated with major clinical events. CONCLUSIONS: PHQ-9 effectively identifies HF patients at risk for increased HCRU and lower QoL. Interventions to reduce depression symptoms may help improve HF outcomes.
BACKGROUND: The Patient Health Questionnaire 9 (PHQ-9) is an effective tool for identification and grading of depression symptoms. Data on PHQ-9 utility for patients with heart failure (HF) are limited. METHODS: We evaluated the severity of depression by PHQ-9 at baseline and its association with health care resource utilization (HCRU) rates and quality of life (QoL) in 308 outpatients enrolled in a prospective HF cohort study. Depression symptoms were stratified according to PHQ-9 score as minimal (0-4), mild (5-9), or moderate-to-severe (10-27). RESULTS: Mean age of patients was 57±11years; 65% were men; 50% were white and 47% black; ejection fraction was 30±15%. Over 24±12months (total: 625person-years), there were 41 (13.3%) major clinical events (34 deaths, 5 transplants, 2 ventricular assist device implantations), 633 all-cause admissions (249 [39.3%] for HF), and 362 emergency department (ED) visits. Moderate-to-severe depressive symptoms were associated with 70% more all-cause admissions compared to patients without depressive symptoms and 2.5 times more HF-related admissions. However, less than 50% of patients with moderate-to-severe symptoms were on antidepressants. In adjusted analyses, even mild depressive symptoms were associated with 57% more all-cause admissions compared to patients without depressive symptoms and more than 2-fold higher rate of HF-related admissions. Depressive symptoms were not associated with ED visits. Increasing PHQ-9 score was associated with progressively worse QoL. PHQ-9 was not associated with major clinical events. CONCLUSIONS: PHQ-9 effectively identifies HF patients at risk for increased HCRU and lower QoL. Interventions to reduce depression symptoms may help improve HF outcomes.
Authors: Emily C Gathright; Elena Salmoirago-Blotcher; Julie DeCosta; Marissa L Donahue; Melissa M Feulner; Dean G Cruess; Rena R Wing; Michael P Carey; Lori A J Scott-Sheldon Journal: Health Psychol Date: 2021-09 Impact factor: 5.556
Authors: Waguih William IsHak; Samuel Korouri; Tarneem Darwish; Brigitte Vanle; Jonathan Dang; Gabriel Edwards; Jeanne T Black; Harriet Aronow; Asher Kimchi; Brennan Spiegel; Rebecca Hedrick; Robert Chernoff; Marcio A Diniz; James Mirocha; Vicki Manoukian; John Harold; Michael K Ong; Kenneth Wells; Michele Hamilton; Itai Danovitch Journal: PLoS One Date: 2021-01-07 Impact factor: 3.240
Authors: Aaron O Koshy; Elisha R Gallivan; Melanie McGinlay; Sam Straw; Michael Drozd; Anet G Toms; John Gierula; Richard M Cubbon; Mark T Kearney; Klaus K Witte Journal: ESC Heart Fail Date: 2020-08-05