Over 400,000 people in the U.S. undergo CABG surgery annually, and approximately one in four experience depression afterwards. Depressed patients tend to experience delayed recovery, poorer quality of life, elevated risk of hospital readmission and death, and higher healthcare costs than those who do not become depressed.
The Bypassing the Blues study involved 453 depressed patients who had undergone CABG and was the first comparative-effectiveness trial to examine the impact of collaborative care for treating depression following an acute cardiac event. The intervention involved a nurse care manager who telephoned patients to educate them about depression, offered various treatment options, and monitored their condition in collaboration with patients’ primary care physicians (PCPs).
As reported earlier by the study team in the Journal of the American Medical Association, intervention patients reported significantly greater improvements in mood symptoms, health-related quality of life, and physical functioning versus patients randomized to their PCPs’ usual care for depression.
In the first cost-effectiveness analyses for treating depression in patients with cardiovascular disease, lead author Julie Donohue, Ph.D., associate professor of health policy and management, University of Pittsburgh Graduate School of Public Health, and the Bypassing the Blues Trial team examined study participants’ Medicare and other insurance claims. Researchers found that patients who underwent intervention had 12-month health care costs that were $449 lower than usual-care patients ($18,172 vs. $18,621).
“Collaborative care has emerged as an integral part of the ‘patient-centered medical home’ model to reorganize and reimburse PCPs for providing high-quality chronic illness care,” Dr. Rollman said. “Demonstrating its cost-effectiveness for post-CABG depression and other cardiovascular conditions is crucial to support its widespread adoption.”
Bypassing the Blues is a National Heart Lung Blood Institute (NHLBI)-funded effectiveness trial conducted through the University of Pittsburgh’s Center for Research on Health Care. These economic analyses were conducted with additional support provided through a grant from the Fine Foundation to Dr. Donohue. For more information on the study, go to http://www.bypassingtheblues.pitt.edu.
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