A patient-centered perspective of treating depressive symptoms in chronic heart failure: What do patients prefer?

Abstract

Objective: To date, very little is known about the specific needs of patients with chronic heart failure (CHF) who must cope with depression. We therefore questioned CHF patients reporting depressive symptoms about their concerns and preferences regarding various psychosocial treatment options. After three-month, we determined how many patients had actually participated in a treatment.

Methods: 85 patients with CHF fulfilling the criteria of a depressive disorder according to the PHQ-9 were investigated. Data were analyzed using descriptive and frequency, as well as logistic regression analyses.

Results: 64.7% of the sample reported that they could envision adhering to supportive talks at longer intervals, whereas only 34.1% would accept an antidepressant. After three months, 24.7% of the patients had actually participated in a treatment. Generalized anxiety severity (GAD-7) was very closely associated with treatment preferences and treatment utilization: The higher the generalized anxiety severity, the more likely was the patients' disposition to begin an antidepressant and/or psychotherapy.

Conclusions: The most favoured treatment option was a low-threshold service with supportive talks.

Practice implications: Future studies investigating the improvement of patient-centred care in CHF patients should include measurements of generalized anxiety.

Keywords: Antidepressant; Chronic heart failure; Depressive symptoms; Patient-centered care; Psycho-social treatment; Psychotherapy.