- Systematic depression screening in patients after acute coronary syndrome (ACS) is not tied to changes in quality-adjusted life years (QALYs), depression-free days, or death, bleeding, or sleep problems.
- No change was seen whether the patients had depression treatment or not in this randomized trial.
Why this matters
- Patients who have elevated depression symptoms after ACS have increased risks for several negative outcomes, suggesting that systematic screening might offer benefit.
- 7.1% of screened survivors had elevated scores on the depression screen.
- Vs patients with ACS not screening positive, QALYs did not differ with screening compared with no screening, regardless of follow-up with positive screen (standard deviation [SD]):
- Screen, notify, treat, −0.06 (0.20);
- Screen and notify, −0.06 (0.20); and
- No screen, −0.06 (0.18; P=.98).
- Other outcomes were similarly unaffected.
- Randomized trial at 4 sites, with 1500 patients (women, 424; men, 1076; mean [SD] age, 65.9 [11.5] years) after ACS with no history of depression.
- Patients were randomly allocated to screen/notify/treat, screen/notify, or no screen (usual care) groups.
- Screening tool was 8-item Patient Health Questionnaire.
- Funding: National Heart, Lung, and Blood Institute.
- Patients in the no-screening group might have become more alert to their own depressive symptoms.
- Treatment was heterogeneous.