The potential influence of depressive symptoms on outcomes from a brief motivational intervention in patients referred to cardiac rehabilitation.

Abstract

Depressive symptoms are associated with poor participation in cardiac rehabilitation (CR). We investigated if depressive symptoms moderate the impact of a brief motivational intervention on CR perceptions and utilization. In this secondary analysis of a randomized controlled trial of motivational interviewing with patients referred to CR (N = 96; 31 % with baseline depressive symptoms; Center for Epidemiologic Studies Depression Scale 10 [CESD-10] >10), regression models tested intervention allocation × CESD-10 interactions on CR attendance/enrollment, intention to attend CR, beliefs and attitudes about CR, barriers, illness perceptions, social support, and exercise self-efficacy. Depressive symptoms were associated with concerns about exercise (p = 0.005), CR barriers (p = 0.042), more threatening illness perceptions (p = 0.001), and lower social support (p < 0.001). CESD-10 scores did not independently moderate intervention outcomes (p > 0.05). There was a three-way intervention × CESD-10 × income effect for perceived CR suitability (adjusted b=0.39, p = 0.007). Depressive symptoms did not influence intervention acceptability (p > 0.05). A brief behaviour change intervention improved CR participation outcomes regardless of depressed mood. Strategies to increase CR adherence should address the interplay of socioeconomic and psychosocial barriers.