Evaluation of Multidisciplinary Collaborative Care in Patients with Acute Coronary Syndrome and Depression and/or Anxiety Disorders

(整期优先)网络出版时间:2017-04-25
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Objective:Toevaluatetheeffectofmultidisciplinarycollaborativecare(MCC)inpatientswithbothacutecoronarysyndrome(ACS)anddepressionand/oranxietydisorderscomparedwithusualphysiciancare(UPC).Methods:Depressionand/oranxietywerescreenedbyusingSDSandSAS,ACSpatientswithdepressionand/oranxietydisorderswererandomizedintoMCCandUPCgroups.Thecardiacoutcomesandthelifequalitywereevaluatedat1yearfollow-up.Results:Overall,30.19%(96/318)patientshadpositivescreenresults.At1year,CardiacoutcomemeasuresforpatientsinMCCgroupweresignificantlybetterforcompositeeventsofcardiacdeathandnon-fatalMI(6.12%vs23.40%,p=0.016),cardiacfunction(NYHAfunctionalclassificationIIIorIV,0%vs25%,p=0.05),andanginapectoris(21.28%vs85%,p<0.0005),thanpatientsinUPCgroup;thelifequalitywereimprovedinpatientsinMCCgroup.Conclusion:AfterACS,30.19%ofpatientshaddepressionand/oranxietydisorders,MCChadbettereffectsoncardiacoutcomesandqualityoflifeinACSpatientswithPsychiatricdisorders.