An IT Approach to Implementing Depression Treatment in Cardiac Patients (iHeart DepCare)
An IT Approach to Implementing Depression Treatment in Cardiac Patients (iHeart DepCare)
The purpose of this study is to examine the effect of a brief electronic shared decision
 making (eSDM) intervention on depressive symptoms in coronary heart disease patients with
 elevated depressive symptoms.
Depression is common in patients with coronary heart disease and associated with increased
 cardiac morbidity and mortality. Treating depressive symptoms appears to improve depressive
 symptoms and quality of life. Despite expert recommendations to screen and treat depressive
 symptoms fewer coronary heart disease patients engage in depression treatment than the
 general population, perhaps due to 1) sub-optimal provider awareness and referral rates and
 2) low self-efficacy, stigma and misattribution of depressive symptoms among coronary heart
 disease patients. In addition, few real world theory-informed implementation trials exist for
 improving screening and treatment in outpatient settings.

 The specific aim is to determine whether an electronic shared decision making (eSDM) and
 behavioral activation tool improves depressive symptoms and treatment initiation in coronary
 heart disease patients with elevated depressive symptoms. To accomplish these aims, a hybrid
 effectiveness-implementation trial will be conducted using a stepped wedge design across
 socioeconomically diverse cardiology and primary care clinics.
Inclusion Criteria:

 -  History of coronary heart disease

 -  English or Spanish Speaking

 -  Elevated Depressive symptoms (PHQ9 ≥10)

 Exclusion Criteria:

 -  Under the care of a psychiatrist (e.g., for schizophrenia)

 -  Diagnosis/history of psychosis or schizophrenia

 -  Diagnosis/history of bipolar disorder

 -  Attempted suicide

 -  Non-English or Spanish speaking

 -  Dementia or severe cognitive impairment

 -  Non-elevated depressive symptoms

 -  Alcohol or substance abuse

 -  Pregnancy