Screening for Depression in Cardiac Rehabilitation: A REVIEW.

PURPOSE: Practice guidelines promote depression screening in cardiac rehabilitation (CR). The objectives of this study were to review (1) CR program compliance with depression screening recommendations, and (2) the evidence evaluating whether screening for depression is related to improved outcomes in patients eligible for CR.

METHODS

A limited literature search was conducted on key resource databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, Evidence-Based Medicine Reviews, SCOPUS, and the University of York Centre for Reviews and Dissemination). A focused Internet search was also conducted with a concentrated gray literature search for evidence reports. Inclusion criteria included English language documents published between January 1, 2002, and August 1, 2013.

RESULTS

Five studies were included in this review. Three studies were found in regard to the first objective and reported varying program compliance rates with depression screening recommendations, ranging from 29.0% to 68.4%. Two studies examined whether depression screening led to improved outcomes in CR-eligible patients. Both studies found that, among patients who recalled being screened, there was no significant difference in depressive symptom scores at followup as compared with patients who were not screened (P > .05).

CONCLUSIONS

Approximately one-third to two-thirds of CR programs routinely screen for depression. There are no randomized controlled trials testing the effects of screening on any outcomes. Although some observational studies suggest that screening alone may not improve patient outcomes, more randomized controlled research is needed to address this issue.