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Indirect costs in patients with coronary artery disease and mental disorders: A systematic review and meta-analysis

100%
Haschke A., Hutter N., Baumeister H.
International Journal of Occupational Medicine and Environmental Health
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2012
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vol. 25
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issue 4
319-329
EN
The aim of the present study was to systematically review the association of comorbid mental disorders with indirect health care costs in patients with coronary artery disease (CAD). A comprehensive database search was conducted for studies investigating persons with CAD and comorbid mental disorders (Medline, EMBASE, PsycINFO, Psyndex, EconLit, IBSS). All studies were included, which allowed for a comparison of indirect health care costs between CAD patients with comorbid mental disorders and CAD patients without mental disorders. The literature search revealed 4962 potentially relevant studies, out of which 13 primary studies met the inclusion criteria. Depression was investigated most often (N = 10), followed by anxiety disorders (N = 3) and any mental disorder not further specifi ed (N = 3). All studies focused on return to work as indirect cost outcome. CAD patients with depression showed diminished odds for return to work, compared to CAD patients without depression (OR = 0.37; 95% CI: 0.27-0.51). The fi ndings for comorbid anxiety and any mental disorder were inconsistent. Indirect health care costs were exclusively assessed by a patient self-report (N = 13). There is strong evidence for diminished odds of return to work in CAD patients with comorbid depression, highlighting the need for integrated CAD and depression care. With regard to other comorbid mental disorders, however, the evidence is sparse and inconclusive.
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Development of short form questionnaires for the assessment of work capacity in cardiovascular rehabilitation patients

88%
Haschke A., Abberger B., Wirtz M., Bengel J., Baumeister H.
International Journal of Occupational Medicine and Environmental Health
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2013
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vol. 26
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issue 5
742-750
EN
Objectives: Prevention of job loss is an essential objective of cardiovascular rehabilitation. However, comprehensive and economic diagnostic instruments on work limitations are missing. The present study describes development of short form questionnaires from 2 domains of the WCIB-Cardio item banks for the assessment of work capacity in cardiovascular rehabilitation patients. Materials and Methods: 283 cardiovascular rehabilitation patients were recruited from 14 German rehabilitation clinics. Based on the WCIB-Cardio with the domains of cognitive and physical work capacity, we developed a short form for both domains. Item selection criteria were content coverage, content appropriateness, internal consistency reliability (≥ 0.8). We used correlation of person location scores of the short forms with person location scores of the full item banks to examine the extent of measurement precision. Results: For each domain of the WCIB-Cardio a short form was developed (cognitive work capacity - 14 items; physical work capacity 7 - items). In both domains psychometric properties were good (person separation index: cognitive work capacity - 0.80; physical work capacity - 0.80). Correlation measures of the short form with the full item banks showed a high accordance of person locations for both domains (cognitive work capacity: r = 0.97; physical work capacity: r = 0.95). Conclusions: The calibrated instrument WCIB-Cardio provides the possibility to develop short form questionnaires with high psychometric quality. These short forms make it possible to monitor patient's work capacity in cardiovascular rehabilitation settings in a more economical way.
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