Psychotherapy, Meds Effective to Treat Depression in Patients With Heart Failure

FRIDAY, Jan. 19, 2024 (HealthDay News) -- For individuals with heart failure and depression, behavioral activation psychotherapy (BA) and antidepressant medication management (MEDS) reduce depressive symptoms, according to a study published online Jan. 17 in JAMA Network Open.

Waguih William IsHak, M.D., from Cedars-Sinai Medical Center in Los Angeles, and colleagues conducted a pragmatic randomized comparative effectiveness trial from 2018 to 2022 with one-year follow-up to compare the effectiveness of BA versus MEDS on patient-centered outcomes among patients with heart failure and depression. Overall, 416 patients were enrolled and randomly assigned to BA or MEDS (208 to each).

At baseline, the mean Patient Health Questionnaire 9-Item (PHQ-9) scores were 14.54 and 14.31 in the BA and MEDS groups, respectively. The researchers found that at three, six, and 12 months, both BA and MEDS recipients experienced nearly a 50 percent reduction in depressive symptoms (e.g., mean score at 12 months: 7.62 and 7.98 for BA and MEDS, respectively). There was no significant between-group difference in the primary outcome of PHQ-9 at six months (mean, 7.53 versus 8.09). Compared with MEDS recipients, BA recipients experienced small improvement in physical health-related quality of life at six months, had fewer emergency department visits at all time points, and spent fewer days hospitalized at all time points.

"Our findings demonstrate that both interventions are comparably effective in reducing depression for patients with heart failure, giving patients, caregivers, and health care practitioners the choice between BA and MEDS, thus improving patient-centered depression care in heart failure," the authors write.

One author disclosed ties to the publishing industry.

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