在POET试验中，部分经口心内膜炎治疗对焦虑和抑郁的影响。

The impact of partial-oral endocarditis treatment on anxiety and depression in the POET trial.

作者信息

Bundgaard Johan S, Iversen Kasper, Pries-Heje Mia, Ihlemann Nikolaj, Bak Theis S, Østergaard Lauge, Gill Sabine U, Madsen Trine, Elming Hanne, Jensen Kaare T, Bruun Niels E, Høfsten Dan E, Fuursted Kurt, Christensen Jens J, Schultz Martin, Rosenvinge Flemming, Schønheyder Henrik C, Helweg-Larsen Jannik, Køber Lars, Torp-Pedersen Christian, Fosbøl Emil L, Tønder Niels, Moser Claus, Bundgaard Henning, Mogensen Ulrik M

机构信息

Department of Cardiology, The Heart Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Department of Cardiology, Herlev-Gentofte University Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

出版信息

J Psychosom Res. 2022 Mar;154:110718. doi: 10.1016/j.jpsychores.2022.110718. Epub 2022 Jan 13.

DOI:10.1016/j.jpsychores.2022.110718

PMID:35078079

Abstract

BACKGROUND

The Partial-Oral versus Intravenous Antibiotic Treatment of Endocarditis Trial (POET) found that partial-oral outpatient treatment was non-inferior to conventional in-hospital intravenous treatment in patients with left-sided infective endocarditis. We examined the impact of treatment strategy on levels of anxiety and depression.

METHODS

Patients completed the Hospital Anxiety and Depression Scale (HADS) at randomization, at antibiotic completion, and after month 3 and month 6. Changes in anxiety and depression (each subdimension 0-21, high scores indicating worse) were calculated using a repeated measure analysis of covariance model with primary assessment after 6 months. Change in score of 1.7 represented a minimal clinical important difference (MCID).

RESULTS

Among the 400 patients enrolled in the POET trial, 263 (66%) completed HADS at randomization with reassessment rates of 86-87% at the three subsequent timepoints. Patients in the partial-oral group and the intravenous group had similar improvements after 6 months in levels of anxiety (-1.8 versus -1.6, P = 0.62) and depression (-2.1 versus -1.9, P = 0.63), although patients in the partial-oral group had numerically lower levels of anxiety and depression throughout. An improvement in MCID scores after 6 months was reported by 47% versus 45% (p = 0.80) patients for anxiety and by 51% versus 54% (p = 0.70) for depression.

CONCLUSION

Patients with endocarditis receiving partial-oral outpatient treatment reported similar significant improvements in anxiety and depression at 6 months, as compared to conventionally treated, but numerically lower levels throughout. These findings support the usefulness of partial-oral treatment.

摘要

背景

心内膜炎部分口服与静脉抗生素治疗试验（POET）发现，在左侧感染性心内膜炎患者中，部分口服门诊治疗不劣于传统的住院静脉治疗。我们研究了治疗策略对焦虑和抑郁水平的影响。

方法

患者在随机分组时、抗生素治疗结束时、3个月和6个月后完成医院焦虑抑郁量表（HADS）。使用重复测量协方差分析模型计算焦虑和抑郁的变化（每个子维度0 - 21分，高分表示情况更糟），主要评估在6个月后进行。得分变化1.7代表最小临床重要差异（MCID）。

结果

在POET试验纳入的400例患者中，263例（66%）在随机分组时完成了HADS，在随后三个时间点的重新评估率为86% - 87%。部分口服组和静脉组患者在6个月后焦虑水平（-1.8对-1.6，P = 0.62）和抑郁水平（-2.1对-1.9，P = 0.63）有相似改善，尽管部分口服组患者在整个过程中的焦虑和抑郁水平在数值上较低。6个月后，焦虑方面报告MCID得分改善的患者为47%对45%（p = 0.80），抑郁方面为51%对54%（p = 0.70）。