Factors associated with general practitioners’ awareness of depression in primary care patients with heart failure: baseline-results from the observational RECODE-HF study

BMC Family Practice

Research Article

Stefan Störk¹  Eva Blozik²  Magdalena Okolo-Kulak²  Nadine Pohontsch²  Agata Kazek²  Anja Rakebrandt²  Marion Eisele²  Sigrid Boczor²  Martin Scherer²  Jens-Martin Träder³  Christoph Herrmann-Lingen⁴ 

[1] Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Straubmühlweg 2a, 97078, Würzburg, Germany;Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany;Department of Primary Medical Care, University of Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany;University of Göttingen Medical Center and German Center for Cardiovascular Research, partner site Göttingen, von-Siebold-Str. 5, D-37099, Göttingen, Germany;

关键词: Depression;    Heart failure;    Recognition of depression;    Observational study;    Primary care;    Health care research;   

DOI  :  10.1186/s12875-017-0641-1

 received in 2016-12-29, accepted in 2017-05-24,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDepression is more prevalent in patients with heart failure (HF) than in those without, but its detection is complicated by the symptom overlap between the two diseases. General practitioners (GPs) are the first point of contact for patients with HF. Therefore, this study aims to investigate GPs’ awareness of depression in their HF patients and factors associated with this awareness.MethodsIn this cross-sectional, observational study 3224 primary care patients with HF were screened for depressive symptomatology using an algorithm based on the Hospital Anxiety and Depression Scale, the 9-item subscale on Depression of the Patient Health Questionnaire, and selected items from the PROMIS Depression and Anxiety scales. The 272 GPs of all patients involved in the study were interviewed by telephone regarding their patients’ somatic and psychological comorbidities. The awareness rates of depressive symptomatology by the patients’ GPs are analyzed using descriptive statistics. Logistic regression analyses are applied to investigate the patient- and GP-based factors associated with the GPs’ awareness of depressive symptomatology.ResultsGPs were aware of their patients’ depressive symptomatology in 35% of all cases. Factors associated with the awareness of depressive symptomatology were: higher patient education levels, a history of depression known to the GP, GP-consultations due to emotional distress within the last 6 months, a higher frequency of GP-contacts within the last 6 months, a higher New York Heart Association (NYHA) classification and more severe depressive symptomatology. The GPs’ characteristics, including further education in psychology/psychiatry, were not associated with GP awareness.ConclusionsMany aspects, including the definition of awareness and the practical issues in primary care, may contribute to the unexpectedly low awareness rates of depressive symptomatology in HF patients in primary care. Awareness rates might increase, if GPs encouraged their patients to talk about emotional distress, held detailed medical interviews including a patient’s history of depression and payed special attention to HF patients with low education levels. However, it remains to be investigated whether GPs’ judgement of depressive symptomatology is a better or worse indicator for the future prognosis and quality of life of HF patients than psychiatry based diagnostic criteria.

【 授权许可】

CC BY   
© The Author(s). 2017