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Open Access Study protocol

Up-Beat UK: A programme of research into the relationship between coronary heart disease and depression in primary care patients

André Tylee1*, Mark Ashworth2, Elizabeth Barley1, June Brown3, John Chambers4, Anne Farmer5, Zoe Fortune1, Mark Haddad1, Rebecca Lawton1, Anthony Mann1, Anita Mehay1, Paul McCrone1, Joanna Murray1, Morven Leese1, Carmine M Pariante6, Diana Rose1, Gill Rowlands7, Alison Smith1 and Paul Walters1

Author Affiliations

1 Health Services and Population Research Dept., Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK

2 Department of Primary Care and Public Health Sciences, King's College London, 9th Floor, Capital House, 42 Weston Street, London, SE1 3QD, UK

3 Department of Psychology, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK

4 Department of Cardiology, Guy's and St Thomas' Hospitals, Westminster Bridge Road, London, SE17EH, UK

5 Department of Social Genetic and Developmental Psychiatry, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK

6 Department of Psychological Medicine, Institute of Psychiatry, King's College London, De Crespigny Park, London, SE5 8AF, UK

7 Faculty of Health and Social Care, London South Bank University, 103 Borough Road, London, SE1 0AA, UK

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BMC Family Practice 2011, 12:38  doi:10.1186/1471-2296-12-38

Published: 23 May 2011

Abstract

Background

Coronary heart disease and depression are both common health problems and by 2020 will be the two leading causes of disability worldwide. Depression has been found to be more common in patients with coronary heart disease but the nature of this relationship is uncertain. In the United Kingdom general practitioners are now being remunerated for case-finding for depression in patients with coronary heart disease, however it is unclear how general practitioners should manage these patients. We aim to explore the relationship between coronary heart disease and depression in a primary care population and to develop an intervention for patients with coronary heart disease and depression.

Methods/design

This programme of research will consist of 4 inter-related studies. A 4 year prospective cohort study of primary care patients with coronary heart disease will be conducted to explore the relationship between coronary heart disease and depression. Within this, a nested case-control biological study will investigate genetic and blood-biomarkers as predictors of depression in this sample. Two qualitative studies, one of patients' perspectives of treatments for coronary heart disease and co-morbid depression and one of primary care professionals' views on the management of patients with coronary heart disease and depression will inform the development of an intervention for this patient group. A feasibility study for a randomised controlled trial will then be conducted.

Discussion

This study will provide information on the relationship between coronary heart disease and depression that will allow health services to determine the efficiency of case-finding for depression in this patient group. The results of the cohort study will also provide information on risk factors for depression. The study will provide evidence on the efficacy and feasibility of a joint patient and professional led intervention and data necessary to plan a definitive randomised controlled trial of the intervention.