Rationale:

Depression increases the risk of mortality among cardiac patients, which may be partly due to reduced adherence to medical treatment regimens by depressed patients. Depressed patients may be less likely to enroll in CR, an effective treatment that has been shown to reduce mortality among cardiac patients. This study examined the hypothesis that patients reporting higher levels of depression symptoms during hospitalization for a cardiac event would be less likely to enroll in a phase II CR program.

Method:

Patients eligible for CR were approached during a hospitalization. The Beck Depression Inventory (BDI) was administered when they were given information about CR and enrollment status was coded 90 days later. Logistic regression was used to evaluate whether or not depression predicted failure to enroll in CR, controlling for age and gender.

Results:

Participants were 194 men (64%) and women (34%) averaging 65 years of age (Range 35-90). The overall enrollment rate was 57%, and 48% for patients scoring >= 10 on the BDI compared to 62% of those with scores < 10 (P = .21). After controlling for gender and age, there was a trend for BDI score (M = 7.6 +/- 6.2, range = 0-30) to predict enrollment in rehab (P = .076). The partial correlation was -.13 (P = .07). Women (46%) were less likely to enroll in rehab compared to men (63%), P = .03.

Conclusion:

Even with a proactive approach to recruitment, and an enrollment rate of 57%, which is higher than other studies, many eligible patients do not enroll in CR. Women are less likely to enroll than men. Contrary to our expectations, in-hospital depression symptoms do not appear to have a large negative effect on enrollment in CR.