2011 Articles

Treatment Preferences among Depressed Patients after Acute Coronary Syndrome: The COPES Observational Cohort

Burg, Matthew M.; Rieckmann, Nina; Clemow, Lynn; Medina, Vivian M.; Schwartz, Joseph E.; Davidson, Karina W.

Depression is associated with significantly poorer medical prognosis after acute coronary syndrome (ACS) [1, 2] . Clinical trials of depression treatment in post-ACS patients have failed to improve event-free survival, and have for the most part shown only modest offsets in depression severity. Among the lessons learned from these efforts is that the intervention must be acceptable to trial participants [3] . The involvement of depressed medical patients in care decisions – e.g. between psychotherapy and pharmacotherapy [4] – enhances both patient engagement and treatment adherence [5, 6] , and results in significantly greater reductions in depression symptom severity and major depression incidence [7] , as we have recently found with ACS patients as well [8] . The treatment preferences of post-ACS patients with elevated depressive symptoms, and correlates of these preferences, have not previously been examined.