Abstract 17979: Nurse Practitioners Recognize, Address Depression-cardiovascular Disease in Older Adults
Depression is a risk factor for as well as a comorbidity of cardiovascular disease (CVD) in older adults (OA). Providers must target efforts toward the prevention, recognition, diagnosis, and treatment of depression to reduce CVD burden and morbidity and mortality among our rapidly growing aging population. While the AHA recommends routine screening for depression in all individuals with heart disease and the scientific community considers elevating depression to the status of "formal" CVD risk factor, depression remains under-diagnosed and sub-optimally treated by cardiology and primary care physicians. Nurse practitioners (NPs), utilizing a biopsychosocial model of care have a significant role in screening, health promotion, and risk reduction efforts and are positioned to play a vital role in primary care. This mixed-method study explored NPs’ knowledge, screening and risk reduction behaviors related to depression-CVD in OA. We hypothesized that NPs integrate depression screening, diagnosis and treatment into CVD risk reduction and management. Methods. A national sample of NPs (N=118) completed an anonymous survey. A subset (n=12) participated in a follow-up interview.
Results: The NPs were aware of the high prevalence of depression among OA with CVD and identified depression as a risk for CVD. One-half were unaware of the AHA recommendation for depression screening or Medicare depression screening and cardiovascular preventive services. Yet, 70% routinely screened their OA patients, and OA patients with CVD for depression. The NPs (92.7%) were confident in their ability to address classic CVD risks and stressed the importance of a quality patient relationship to optimize depression care. A majority (64%) felt it would be at least “somewhat” easy to incorporate depression into their routine CVD risk reduction practices if depression became a “formal” CVD risk factor. Inadequate counseling skills and lack of mental health resources were cited as challenges. Conclusions. NPs are confident in their ability to promote CVD risk reduction among their OA patients and recognize and address depression in cardiovascular care. They are prepared to incorporate depression into CVD risk reduction practice but lack depression counseling resources.
Author Disclosures: L.M. Novosel: None. S.A. Smialek: None.
- © 2015 by American Heart Association, Inc.