Dr. Thomas W. Cline, consumer psychologist and professor of marketing and statistics at the Saint Vincent College Alex G. McKenna School of Business, Economics and Government, co-authored two articles in Critical Care Nursing Quarterly.
“Over the past year, I conducted research with several colleagues on identifying warning signs of post-heart attack depression and readmission rates for congestive heart failure (CHF) patients who were implanted with the CorVue Implantable Cardioverter Defibrillator (ICD). No patients with a CorVue ICD experienced a 30-day readmission. In contrast, 14 of 60 patients (23.3 percent) without the CorVue device experienced 30-day readmission.
Both manuscripts were published, back-to-back, in the Critical Care Nursing Quarterly’s April/June 2017 issue (volume 40, issue 2, pp. 111-136).
“Coronary artery disease (CAD) is the leading cause of death in the United States,” Cline commented. “The World Bank and the World Health Organization predict that depression and coronary heart disease will be the largest causes of global health burden and disability by the year 2020. Studies have demonstrated that patients with CAD experience depression at a higher rate than the general population. Because of this connection, it is critical to recognize depression and manage depression effectively for people with CAD. Studies have also provided evidence that identifying and treating depression in patients early after a myocardial infarction improve clinical outcomes. In addition, a number of studies have discussed the negative effects that can occur from untreated depression in these patients. The cited negative effects include mortality, recurrent myocardial events and a worse quality of life. The article entitled, An Analysis of the Prevalence of Depression Post-Myocardial Infarction, discusses the results of a research that was completed at a cardiology office using a retroactive medical record review that focused on outpatients with cardiac diseases. The primary aim of the study was to collect data using the Patient Health Questionnaire-9 (PHQ-9), a public domain screening tool. This research was intended to provide evidence that would support using the PHQ-9 as a standard depression screening tool for patients post-myocardial infarction. By recognizing the symptoms of depression, the patient would then be treated accordingly.” The other co-authors included Jessica DiSante of South Hills Physical Medicine, Angela Macci Bires of Robert Morris University and Kristen Waterstram-Rich of Rochester Institute of Technology.
“Heart failure (HF) is a serious medical problem in the United States and is placing a financial strain on the health care system,” Cline continued. “It is the leading cause of mortality and as the overall incidence continues to increase, so does the economic impact on the health care system. Innovative treatment options, in the form of disease management programs and implantable cardiac devices, such as the CorVue capable implantable cardioverter defibrillator (ICD) pacemaker, offer the promise of an enhanced quality of life and reduced mortality. Even with these advances, HF continues to be a challenge. Studies reviewing HF management programs have shown promising results. However, more studies are needed to determine which combination of HF management interventions has the greatest financial impact and yields the best patient outcomes. The objective of the research study, Improving Clinical Outcomes for Patients with Class III Heart Failure, was to compare 30-day readmission rates of patients implanted with the CorVue capable ICD pacemaker with patients with congestive heart failure (CHF) with no implanted device. The aim of the research focused on the usefulness of intrathoracic impedance monitoring alerts in guiding empirical treatment of patients with CHF to prevent HF readmissions. Methodology included a retrospective medical chart review, comparing 30-day readmission events among patients with class III CHF who received home health intervention with similar patients implanted with the CorVue ICD.” The other co-authors included Melissa Shapiro of the Washington Hospital Health System, Angela Macci Bires of Robert Morris University and Kristen Waterstram-Rich of Rochester Institute of Technology.
Photo: Dr. Thomas W. Cline
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