CHÉOS Scientist Dr. Martha Mackay is launching a new pilot study that will test the effectiveness of an intervention to reduce depression in people who have recently experienced a serious heart event.

Depression following a major cardiac event is extremely common — approximately one in five people in this population will experience depression — and it can be detrimental to their recovery and overall cardiac health.
“Major depression in people hospitalized after a cardiac event is associated with worse outcomes, even death,” said Dr. Mackay, a Clinical Nurse Specialist in the Heart Centre at St. Paul’s Hospital “Even when researchers control for exercise, medication adherence, and attendance at a cardiac rehabilitation program, the association is still strong.”

The strength of this association has led the American Heart Association to list depression as a risk factor for poor cardiac health, alongside other risks such as smoking, obesity, and diabetes.

The mechanism behind this relationship is not well understood but may involve a common physiological pathway in the form of inflammation or endothelial dysfunction.

Dr. Mackay’s pilot study will utilize internet-based cognitive behavioural therapy (iCBT) in which patients complete online modules outlining cognitive-behavioural skills for depression, in conjunction with therapist support via email. Previous research has shown that the combination of online modules and therapist interaction is as efficacious as traditional, face-to-face CBT.

“We are very interested to see if this intervention will improve cardiac outcomes,” said Dr. Mackay, “relatively little is known about how and to what extent iCBT will help heart health.”

“If successful, an electronic intervention of this sort will be very valuable because it will improve access to care for rural communities and spread scarce resources wider, which will allow better access to treatment for more people,” said Dr. Mackay.

The pilot study will begin recruiting in February and will follow approximately 40 patients for a period of six to nine months. If successful, Dr. Mackay and her team will move forward to secure funding for a larger trial of about 1000 patients.

This project is a part of a program of research led Dr. Mackay. She is also involved in a study that is implementing a depression screening tool as a part of routine care in cardiac inpatients at St. Paul’s Hospital. This project is part of the inaugural Knowledge Translation Challenge.