The effects of anti-depressants on depression symptom scores at 12 months follow-up in patients with cardiometabolic disease: Results from a large primary care cohort

Bhautesh Dinesh Jani; David Purves; Sarah J E Barry; Colin McCowan; Jonathan Cavanagh; Frances S Mair

doi:10.4103/2249-4863.161324

The effects of anti-depressants on depression symptom scores at 12 months follow-up in patients with cardiometabolic disease: Results from a large primary care cohort

J Family Med Prim Care. 2015 Jul-Sep;4(3):373-9. doi: 10.4103/2249-4863.161324.

Authors

Bhautesh Dinesh Jani¹, David Purves², Sarah J E Barry², Colin McCowan², Jonathan Cavanagh³, Frances S Mair¹

Affiliations

¹ General Practice and Primary Care, Sackler Institute, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Southern General Hospital, University of Glasgow, Glasgow, United Kingdom.
² Robertson Centre for Biostatistics, Sackler Institute, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Southern General Hospital, University of Glasgow, Glasgow, United Kingdom.
³ Mental Health and Wellbeing, Sackler Institute, Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, Southern General Hospital, University of Glasgow, Glasgow, United Kingdom.

Abstract

Background: Evidence on the long-term usefulness of anti-depressants in managing depression in cardiometabolic disease is limited.

Aim: We examined the effects of anti-depressant prescribing on depressive symptoms at 12 months follow-up in patients with cardiometabolic disease and a positive depression screening result at baseline.

Design and setting: We retrospectively reviewed routine UK primary care data for patients with coronary heart disease, diabetes and previous stroke for the year 2008-2009. 35,537 patients with one of the three above diseases underwent depression screening using the Hospital Anxiety and Depression Scale (HADS-D). Of 7080 patients with a positive screening result (HADS-D ≥ 8), 3933 (55.5%) patients had a repeat HADS-D recorded at 12 months follow-up.

Methods: We compared the change in HADS-D at follow-up and remission rate in those who were prescribed anti-depressants (n = 223) against those who were not (n = 3710).

Results: The mean change in HADS-D from baseline, for the nonprescribed group was similar to the reduction observed in patients who were continuously prescribed (n = 93) with anti-depressants during follow-up. Patients who were prescribed intermittently (n = 72) or only one (n = 58) prescription during follow-up had a lower reduction in HADS-D compared to the nonprescribed group. There was no difference in remission rates between continuously prescribed and the nonprescribed group, but remission was lower in patients prescribed intermittently and single prescription.

Conclusion: Improvement in depressive symptoms in patients with cardiometabolic disease at 12 months was not any better in patients prescribed with anti-depressants compared to the nonprescribed group. The role of anti-depressants in the management of depression in cardiometabolic disease merits further investigation.

Keywords: Anti-depressants’ effectiveness; anti-depressants’ efficacy; cardiometabolic disease; coronary heart disease; depression; diabetes; primary care; stroke.