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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EResults from the Bypassing the Blues trial [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00091962\u0026amp;atom=%2Fspmdc%2F9%2F5%2F16.atom\u0022\u003ENCT00091962\u003C\/a\u003E] indicate that depression screening shortly after coronary artery bypass graft surgery (CABG), telephone follow-up using evidence-based depression treatment protocols, and patient education that is supervised by primary care physicians (ie, collaborative care) can improve health-related quality of life, physical functioning, and mood symptoms and thereby speed patient recovery following CABG surgery.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EMood Disorders Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EInterventional Techniques \u0026amp; Devices\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EResults from the Bypassing the Blues trial (\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT00091962\u0026amp;atom=%2Fspmdc%2F9%2F5%2F16.atom\u0022\u003ENCT00091962\u003C\/a\u003E) indicate that depression screening shortly after coronary artery bypass graft (CABG) surgery, telephone follow-up using evidence-based depression treatment protocols, and patient education that is supervised by primary care physicians (ie, collaborative care) can improve health-related quality of life (HRQoL), physical functioning, and mood symptoms and thereby speed patient recovery following CABG surgery.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EPost-CABG depression is common (20% to 25% incidence) and has been associated with delayed recovery, increased hospital readmissions, cardiovascular events, and death. The Bypassing the Blues trial was designed to test the effectiveness of a telephone-delivered collaborative care strategy for treating post-CABG depression versus doctors\u0027 usual care. Post-CABG patients who expressed mood symptoms that were indicative of depression (Patient Health Questionnaire [PHQ-2] positive screen) preceding discharge, followed by a PHQ-9 score \u226510 at 2 weeks posthospitalization, were randomly assigned to an 8-month course of collaborative care (n=150) or their physicians\u0027 \u201cusual care\u201d (n=152). Results were also compared with a group of 151 randomly sampled nondepressed post-CABG patients (PHQ-2 negative and PHQ-9 \u0026lt;5).\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe intervention consisted of telephone contact at regular intervals, during which the nurses provided basic psycho education, assessed treatment preferences (eg, self-management workbook, antidepressant pharmacotherapy, referral to a mental health specialist), monitored treatment response, and suggested changes to patients and their primary care physicans (PCP) following a discussion with a study psychiatrist and PCP. The study investigators did not prescribe or dispense any antidepressant medications, and patients who were interested in pharmacotherapy were required to obtain this treatment from their PCP and at cost. No pharmaceutical or industry support was involved in this trial.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EThe primary outcome measure was mental HRQoL, as measured by the Short Form-36 Mental Component Summary (SF-36 MCS) at 8 months. Secondary outcome measures included assessment of mood symptoms (Hamilton Rating Scale for Depression [HRS-D]), physical HRQoL (SF-36 PCS), and functional status (Duke Activity Status Index [DASI]); and rehospitalization rate.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe 302 depressed subjects were well matched by baseline randomization status; however, depressed subjects were slightly younger than those in the nondepressed comparison group (mean age 64 vs 66 years; p=0.03). Approximately 25% of depressed patients were already using an antidepressant medication at baseline.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EDepressed subjects who were randomized to collaborative care experienced a significant improvement in HRQoL compared with subjects in the usual care group beginning at 2 month follow-up that was equivalent to a small to moderate effect size (ES) of 0.30 (95% CI, 0.17 to 0.52; p=0.01) and a number needed to treat (NNT) of 4.9 (3.2 to 10.4; p\u0026lt;0.001) to achieve a 50% or greater decline from baseline HRS-D score. The improvement in mood symptoms appeared to be more prominent in men (ES, 0.53; 95% CI, 0.23 to 0.84; p\u0026lt;0.001). Patients who received collaborative care also had improved scores on the HRS-D for mood symptoms (ES, 0.30; 95% CI, 0.08 to 0.53; p=0.009), the SF-36 PCS (ES, 0.26; 95% CI, 0.03 to 0.48; p=0.03) for physical status, and DASI (ES, 0.32; 95% CI, 0.09 to 0.54; p=0.006) for physical functioning. The mean HRQoL and physical functioning of patients who received intervention did not reach those of the nondepressed comparison group for any of the measures.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EOverall, while there was no difference in the incidence of rehospitalization between study arms by randomization status, there was a trend toward fewer rehospitalizations for cardiovascular causes among depressed men who were randomized to their intervention (13%) versus men who were randomized to usual care (25%; p=0.07). However, the study was underpowered to detect a difference in cardiovascular events of mortality (1% overall mortality by 8-month follow-up). Cost data are not yet available.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EThe study results were presented by Bruce L. Rollman, MD, University of Pittsburgh, Pittsburgh, PA, the primary investigator of the study.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2009 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section ref-list\u0022 id=\u0022ref-list-1\u0022\u003E\u003Ch2 class=\u0022\u0022\u003EAdditional Reading\u003C\/h2\u003E\u003Col class=\u0022cit-list ref-use-labels\u0022\u003E\u003Cli\u003E\u003Cspan class=\u0022ref-label ref-label-empty\u0022\u003E\u003C\/span\u003E\n            \u003Cdiv class=\u0022cit ref-cit ref-journal no-rev-xref\u0022 id=\u0022cit-9.5.16.1\u0022 data-doi=\u002210.1001\/jama.2009.1670\u0022\u003E\u003Cdiv class=\u0022cit-metadata\u0022\u003E\u003Col class=\u0022cit-auth-list\u0022\u003E\u003Cli\u003E\u003Cspan class=\u0022cit-auth\u0022\u003E\u003Cspan class=\u0022cit-name-surname\u0022\u003ERollman\u003C\/span\u003E  \u003Cspan class=\u0022cit-name-given-names\u0022\u003EBL\u003C\/span\u003E\u003C\/span\u003E, \u003C\/li\u003E\u003Cli\u003E\u003Cspan class=\u0022cit-etal\u0022\u003Eet al\u003C\/span\u003E\u003C\/li\u003E\u003C\/ol\u003E\u003Ccite\u003E. \u003Cspan class=\u0022cit-article-title\u0022\u003ETelephone-Delivered Collaborative Care for Treating Post-CABG Depression: A Randomized Controlled Trial\u003C\/span\u003E. \u003Cabbr class=\u0022cit-jnl-abbrev\u0022\u003EJAMA\u003C\/abbr\u003E \n               \u003Cspan class=\u0022cit-pub-date\u0022\u003E2009\u003C\/span\u003E;\u003Cspan class=\u0022cit-vol\u0022\u003E302\u003C\/span\u003E:\u003Cspan class=\u0022cit-fpage\u0022\u003E2095\u003C\/span\u003E\u2013\u003Cspan class=\u0022cit-lpage\u0022\u003E2103\u003C\/span\u003E.\u003C\/cite\u003E\u003C\/div\u003E\u003Cdiv class=\u0022cit-extra\u0022\u003E\u003Ca href=\u0022{openurl}?query=rft.jtitle%253DJAMA%26rft_id%253Dinfo%253Adoi%252F10.1001%252Fjama.2009.1670%26rft_id%253Dinfo%253Apmid%252F19918088%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx\u0022 class=\u0022cit-ref-sprinkles cit-ref-sprinkles-openurl cit-ref-sprinkles-open-url\u0022\u003E\u003Cspan\u003EOpenUrl\u003C\/span\u003E\u003C\/a\u003E\u003Ca href=\u0022\/lookup\/external-ref?access_num=10.1001\/jama.2009.1670\u0026amp;link_type=DOI\u0022 class=\u0022cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref\u0022\u003E\u003Cspan\u003ECrossRef\u003C\/span\u003E\u003C\/a\u003E\u003Ca href=\u0022\/lookup\/external-ref?access_num=19918088\u0026amp;link_type=MED\u0026amp;atom=%2Fspmdc%2F9%2F5%2F16.atom\u0022 class=\u0022cit-ref-sprinkles cit-ref-sprinkles-medline\u0022\u003E\u003Cspan\u003EMedline\u003C\/span\u003E\u003C\/a\u003E\u003Ca href=\u0022\/lookup\/external-ref?access_num=000271873900018\u0026amp;link_type=ISI\u0022 class=\u0022cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience\u0022\u003E\u003Cspan\u003EWeb of Science\u003C\/span\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003C\/li\u003E\u003Cli\u003E\u003Cspan class=\u0022ref-label ref-label-empty\u0022\u003E\u003C\/span\u003E\n            \u003Cdiv class=\u0022cit ref-cit ref-journal no-rev-xref\u0022 id=\u0022cit-9.5.16.2\u0022 data-doi=\u002210.1097\/PSY.0b013e3181970c1c\u0022\u003E\u003Cdiv class=\u0022cit-metadata\u0022\u003E\u003Col class=\u0022cit-auth-list\u0022\u003E\u003Cli\u003E\u003Cspan class=\u0022cit-auth\u0022\u003E\u003Cspan class=\u0022cit-name-surname\u0022\u003ERollman\u003C\/span\u003E  \u003Cspan class=\u0022cit-name-given-names\u0022\u003EBL\u003C\/span\u003E\u003C\/span\u003E, \u003C\/li\u003E\u003Cli\u003E\u003Cspan class=\u0022cit-etal\u0022\u003Eet al\u003C\/span\u003E\u003C\/li\u003E\u003C\/ol\u003E\u003Ccite\u003E. \u003Cspan class=\u0022cit-article-title\u0022\u003EThe Bypassing the Blues Treatment Protocol: Stepped Collaborative Care for Treating Post-CABG Depression\u003C\/span\u003E. \u003Cabbr class=\u0022cit-jnl-abbrev\u0022\u003EPsychosomatic Medicine\u003C\/abbr\u003E \n               \u003Cspan class=\u0022cit-pub-date\u0022\u003E2009\u003C\/span\u003E;\u003Cspan class=\u0022cit-vol\u0022\u003E71\u003C\/span\u003E:\u003Cspan class=\u0022cit-fpage\u0022\u003E217\u003C\/span\u003E\u2013\u003Cspan class=\u0022cit-lpage\u0022\u003E230\u003C\/span\u003E.\u003C\/cite\u003E\u003C\/div\u003E\u003Cdiv class=\u0022cit-extra\u0022\u003E\u003Ca 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