title: Long-term efficacy of a tele-health intervention for acute coronary syndrome patients with depression: 12-month results of the MoodCare randomized controlled trial.
abstract: BACKGROUND
  Depression is common after a cardiac event; however it often remains untreated. Previously, we reported the efficacy and feasibility of a 6-month tele-health programme (MoodCare), which integrates depression management into a cardiovascular disease (CVD) risk reduction programme for Acute Coronary Syndrome (ACS) patients with low mood. Here, we evaluate the long-term efficacy of the programme at 12-month follow-up.
  
  
  METHODS
  A two-arm, parallel, randomized design to compare the long-term effects of 'MoodCare' (n = 61) to usual care (UC) (n = 60) at 12 months.
  
  
  METHODS
  121 ACS patients recruited from six hospitals in Victoria and Brisbane, Australia were randomized to a telephone-delivered cognitive behavioural therapy and risk-reduction programme or usual medical care. Mixed-model repeated measurements (MMRM) analysis was applied with results expressed as estimated marginal mean changes in depression and health-related quality of life (HRQOL) outcomes by group.
  
  
  RESULTS
  After 12 months, treatment effects were observed for those with major depressive disorder (MDD) for PHQ-9 depression (MoodCare: mean score: 6.5; 95% CI: 4.9-8.0 versus UC: 9.3; 95% CI: 7.7-10.9, p = 0.012)) and SF-12 mental health scores (MoodCare: 42.5; 95% CI: 39.8-45.2 versus UC: 36.8; 95% CI: 34.1-39.6, p = 0.005). No beneficial treatment effects were observed in those with no MDD at baseline.
  
  
  CONCLUSIONS
  After 12 months, MoodCare was superior to UC for improving mental health outcomes for those with a clinical diagnosis of major depression. Our findings support the implementation of depression-based interventions for cardiac patients with a clinical diagnosis of depression and provide evidence of longer term efficacy to one year.
authors.affiliation: School of Medicine, Deakin University, Victoria, Australia School of Public Health and Preventive Medicine, Monash University, Victoria, Australia A.ONEIL@deakin.edu.au.
authors.forename: Adrienne
authors.initials: A
authors.lastname: O'Neil
authors.affiliation: Department of Psychiatry, Stanford University, CA, USA.
authors.forename: Barr
authors.initials: B
authors.lastname: Taylor
authors.affiliation: University of Melbourne and Department of Cardiology, Austin Hospital, Victoria, Australia.
authors.forename: David L
authors.initials: DL
authors.lastname: Hare
authors.affiliation: Menzies Research Institute Tasmania, University of Tasmania, Australia.
authors.forename: Kristy
authors.initials: K
authors.lastname: Sanderson
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Victoria, Australia.
authors.forename: Sheila
authors.initials: S
authors.lastname: Cyril
authors.affiliation: School of Medicine, Deakin University, Victoria, Australia.
authors.forename: Kamalesh
authors.initials: K
authors.lastname: Venugopal
authors.affiliation: Institute for Safety, Compensation and Recovery Research, Monash University, Victoria, Australia.
authors.forename: Bianca
authors.initials: B
authors.lastname: Chan
authors.affiliation: Department of Cardiology, The Royal Brisbane and Women's Hospital, Queensland, Australia Department of Medicine, University of Queensland, Queensland, Australia.
authors.forename: John J
authors.initials: JJ
authors.lastname: Atherton
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, Queensland, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Hawkes
authors.affiliation: Department of Cardiology, The Price Charles Hospital, Queensland, Australia.
authors.forename: Darren L
authors.initials: DL
authors.lastname: Walters
authors.affiliation: School of Public Health and Preventive Medicine, Monash University, Victoria, Australia School of Population and Global Health, University of Melbourne, Melbourne.
authors.forename: Brian
authors.initials: B
authors.lastname: Oldenburg
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D000339:Affect; D015928:Cognitive Behavioral Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011793:Queensland; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000379:methods*; D013689:Telephone; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria
keywords: Depression; acute coronary syndrome; cardiac; cognitive behaviour therapy; tele-health