Question

Question: Following acute coronary syndrome (ACS), is depression care effective for the treatment of depression symptoms?

Patients: In total, 150 adults (age ≥35 years) with elevated depressive symptoms (Beck depression inventory (BDI) score ≥10 on two screens or ≥15 on one screen) 2–6 months after hospitalisation for ACS.

Setting: Five academic centres across the USA; March 2010–January 2012.

Intervention: Centralised depression care according to patient preference (intervention) or locally determined depression care (usual care), for 6 months. Participants randomised to centralised depression care could choose whether to receive problem-solving treatment (PST), pharmacological treatment, both, or neither. PST involved a manualised, problem-solving form of cognitive behavioural therapy, delivered initially through video call, and subsequently through video call or telephone, at home or a clinic, according to preference. Pharmacological treatment was selected on an individual basis, following consultation between patient and healthcare provider. Professionals involved in providing centralised care met weekly to review treatment and discuss the need to step-up treatment every 6–8 weeks depending on the response. In the usual care group, the …