Depression and heart disease: Promoting awareness and intervention across the continuum of care.

Heart disease patients have twice the risk of having depression compared to others. This results in poor quality of life and higher rates of death and complications. Treatment for depression can reduce depression symptoms, improve quality of life, and may lessen poor outcomes.

A first step to treating depression is diagnosis. We have implemented pre-discharge depression screening on the cardiac inpatient units at St. Paul's Hospital. This information is then sent to their primary care provider (PCP). However, we are unsure of the best way to get this information to PCPs. We also believe there are barriers to PCPs helping cardiac patients with depression, such as low awareness of its association with bad cardiac outcomes, little time for screening and few community mental health resources. We propose a 4-phase approach to address these barriers.

To start, we will solicit input from some PCPs (from urban and rural settings) on ways to receive information about depression screening of recently hospitalized patients, and the barriers faced in helping depressed cardiac patients.

We will then develop resources for both patients and PCPs, such as an infographic (patients) and web-based resources on the 'Pathways'site (PCPs), followed by implementation of the PCP communication process and evaluation of the web-based resource usage.

Finally, we will introduce our screening protocol to nursing leaders at BC's large cardiac centres, to promote broad uptake of this practice.