By AMERICAN HEART ASSOCIATION NEWS

depressed

ARLINGTON, Virginia — Veterans with heart disease and depression are more likely than those without depression to struggle paying for medications and medical visits and often report delays in seeking medical care, according to a new study.

Compared to veteran heart patients without depression, those with depression were about twice as likely to report difficulty affording medical care, twice as likely to report delays in seeking medical care and 45 percent more likely to report difficulty affording prescription drugs, researchers said Monday at the American Heart Association’s Quality of Care and Outcomes Research 2017 Scientific Sessions.

“All healthcare providers who treat veterans with depression should routinely ask their patients about any difficulty with being able to pay for medical care or medications,” said Puja Parikh, M.D., M.P.H., an interventional cardiologist and assistant professor at Stony Brook School of Medicine and director of invasive cardiology at the Northport Veterans Affairs Medical Center in New York.

“In some cases, less expensive medications can be considered and 90-day supply of drugs can be prescribed instead of a 30-day supply that can reduce costs. We can also recommend working with a social worker to obtain vouchers or coupons from pharmaceutical companies to get further financial assistance with medication costs.”

Researchers used data from the Centers for Disease Control and Prevention’s 2013 Behavioral Risk Factor Surveillance System survey to study 13,126 veterans who reported being told by a health professional that they had a heart attack, stroke, angina or coronary heart disease. Twenty-two percent said they were diagnosed with depression.

Veteran heart patients with depression were more likely to be older and non-white, less likely to be employed and own a home, and had lower annual income. They had higher rates of high blood pressure, elevated cholesterol, chronic obstructive pulmonary disease (a lung disease that causes breathing difficulty), chronic kidney disease, asthma, smoking, obesity and lack of physical inactivity.

The survey didn’t discern whether the veterans received care at Department of Veterans Affairs facilities or other non-VA facilities.

Healthcare providers also should screen veterans for depression and monitor them for electrocardiogram abnormalities if they’re taking anti-depressant medications, because certain psychiatric drugs can predispose some patients to develop arrhythmias, Parikh said. They should also counsel patients on how to take their cardiac medications.

Because depressed veteran heart patients are likely to have multiple chronic medical illnesses, they should be followed by a primary care doctor, psychiatrist and cardiologist.