Mental health issues associated with cardiovascular disease in women

Stakeholder-led understanding of the implementation of digital technologies within heart disease diagnosis: a qualitative study protocol

INTRODUCTION

Cardiovascular diseases are highly prevalent among the UK population, and the quality of care is being reduced due to accessibility and resource issues. Increased implementation of digital technologies into the cardiovascular care pathway has enormous potential to lighten the load on the National Health Service (NHS), however, it is not possible to adopt this shift without embedding the perspectives of service users and clinicians.

METHODS AND ANALYSIS

A series of qualitative studies will be carried out with the aim of developing a stakeholder-led perspective on the implementation of digital technologies to improve holistic diagnosis of heart disease. This will be a decentralised study with all data collection being carried out online with a nationwide cohort. Four focus groups, each with 5-6 participants, will be carried out with people with lived experience of heart disease, and 10 one-to-one interviews will be carried out with clinicians with experience of diagnosing heart diseases. The data will be analysed using an inductive thematic analysis approach.

ETHICS AND DISSEMINATION

This study received ethical approval from the Sciences and Technology Cross Research Council at the University of Sussex (reference ER/FM409/1). Participants will be required to provide informed consent via a Qualtrics survey before being accepted into the online interview or focus group. The findings will be disseminated through conference presentations, peer-reviewed publications and to the study participants.

Depression and anxiety associated with cardiovascular disease among persons aged 45 years and older in 38 states of the United States, 2006

OBJECTIVE

To highlight the close association of cardiovascular disease (CVD) with depression and anxiety in US non-institutionalized adults and examine the sociodemographic correlates of depression and anxiety among CVD survivors.

METHOD

The data were obtained from 38 states which administered an Anxiety and Depression Module as part of the 2006 Behavioral Risk Factor Surveillance System. CVD was assessed with three questions on coronary heart disease and stroke. Adjusted prevalence ratios (APRs) were obtained after adjustment for demographic characteristics using SUDAAN 9.0.

RESULTS

The prevalence of a CVD history was 15.3% among studied population (sample size n=129,499). Persons with a CVD history were more likely than those without to experience current depression (15.8% versus 7.1%, APR [95% CI]=1.69 [1.54-1.85]), to have a lifetime diagnosis of depressive disorders (22.3% versus 15.1%, APR [95% CI]=1.56 [1.45-1.67]) or anxiety disorders (16.6% versus 10.0%, APR [95% CI]=1.46 [1.37-1.54]). CVD survivors with low education attainment or minority background were less likely to receive a diagnosis of depression though their experience of depression was comparable with or higher than their counterparts.

CONCLUSION

CVD is associated significantly with depression and anxiety. Disparities exist among CVD survivors on the diagnosis of depression and anxiety.

Factors influencing psychotropic prescription by non-psychiatrist physicians in a nursing home for the elderly in Brazil

CONTEXT AND OBJECTIVE

Although psychotropics are one of the classes of medications most prescribed in nursing homes for the elderly, studies examining prescribing patterns are limited in both number and scope. The present study was undertaken to investigate factors associated with general psychotropic use in a nursing home in Brazil.

DESIGN AND SETTING

Retrospective observational study at the Nursing Home for the Elderly, Institute of Biosciences, Universidade Estadual Paulista.

METHODS

Information on prescriptions was retrieved from the medical records of 108 elderly residents in a nursing home. Sixty-five of these patients, with mean age 74.5 years (+/-standard deviation 9.4 years), who were taking medications on a regular basis, comprised the sample. The effects of demographic and clinical variables on the psychotropic prescription pattern were examined.

RESULTS

Females were more likely to receive psychotropics (p = 0.038). Individuals on medicines for cardiovascular diseases received psychotropics less frequently (p = 0.001). The number of prescribed psychotropics correlated negatively with both age (p = 0.009) and number of non-psychotropic drugs (p = 0.009).

CONCLUSIONS

Although preliminary, the present results indicated that cardiovascular disease was the clinical variable that most influenced psychotropic prescription. Physicians' overconcern regarding drug interactions might at least partially explain this result. Further investigations involving larger sample sizes from different regions are warranted to confirm these findings.