Benefits of collaborative care for post-CABG depression are not related to adjustments in antidepressant pharmacotherapy

AbstractObjective ermine whether the use and adjustment of antidepressant pharmacotherapy accounted for the beneficial effects of collaborative care treatment on the improvement of mood symptoms and health-related quality of life (HRQoL) after coronary artery bypass graft (CABG) surgery. s ost-hoc analysis of data from the Bypassing the Blues (BtB) trial we tested the impact of antidepressant medication on changes in depression and HRQoL from the early postoperative period to 8-month follow-up. Two hundred fifty-nine depressed post-CABG patients scoring ≥ 10 on the Patient Health Questionnaire-9 were classified in four groups according to whether or not they received antidepressants at baseline and 8-months following randomization. s ts using antidepressant pharmacotherapy at baseline and follow-up tended to be younger and female (p≤0.01), but were similar in various clinical characteristics. Just 24% (63/259) of patients were on an antidepressant at baseline which increased to 36% at follow-up (94/259). Compared to other groups, patients on antidepressants at both baseline and follow-up assessment showed the smallest improvement in mood symptoms and HRQoL. While multivariate analyses confirmed that randomization to collaborative care was associated with greater improvement in mood symptoms (odds ratio [OR] = 3.1; 95%-confidence interval [CI] = 1.8–5.4, p < 0.0001) and mental HRQoL (OR = 3.6, CI = 1.4–9.3, p = 0.01), use of antidepressant medication had no differential impact on either measure (p = 0.06 and p = 0.92, respectively). sion neficial effects of collaborative care for post-CABG depression were not generated by adjustments in antidepressant medication. Registration: Clinicaltrials.gov Identifier: NCT00091962. //clinicaltrials.gov/ct2/show/NCT00091962?term=rollman+cabg&rank=1).