A Critical Review And Local Audit Of The Prevalence Of Mental Ill-Health In Heart Failure Patients

Objective: To establish if depression results in poor adherence to therapy in patients with heart diseases. Methods: This concept scoping study was conducted in two phases; the first was a systematic review of the literature, and the second part was local data analysis. Statistical analysis was performed using RevMan® V.5.3 (Cochrane Community). Results: Patients who received multidisciplinary collaborative care showed significantly reduced major adverse cardiac outcomes in patients with cardiovascular diseases. They also demonstrated higher rates of self-reported remission of depression. The review also showed endpoint mortality after PCI was associated with patients having depression. Local population data showed that 26% of heart failure patients had mental ill health comorbidity, however, only 12% had a formal diagnosis recorded. Conclusion: Depression is associated with poor cardiac outcomes in patients with coronary artery disease. It is widespread in patients with cardiovascular disease and must be screened for throughout the management plan.

A Critical Literature Review And Audit Of Real World Data To Inform The Relationship Between Mental Ill-Health And Type-2 Diabetes Favourable Prognosis

Objective: The aim of this scoping study was to identify gaps in the current literature and understand the T2DM and MIH comorbidity trends in the local population from the West Midlands, UK to inform future studies. Methods: This project was a scoping study of two parts; a critical review and a clinical audit. A thematic approach was used to group studies based on their overall study outcome. The clinical audit data was used to compare the local patient population to the patterns identified in the literature reviewed. Results: The reviewed studies reported a relationship between T2DM control and both depression and anxiety, but did not agree on its significance. The clinical audit of 71 patients diagnosed with T2DM showed that 73% of males presented with poor diabetes control (HbA1c>7) compared to females (46%). Conversely, females exhibited a higher prevalence of MIH (45%) compared to males (31%). Conclusion: From both this audit of the literature and local data, it remains unclear whether mental-ill health is a major driver for medication non-adherence behaviour and uncontrolled diabetes. Further studies are recommended to further understand this comorbidity.