Dear (HEALTH PLAN) provider:
As the nation’s No. 1 killer of men and women and a leading cause of disability, heart disease
exacts a high toll on your patients. One way that you can support your patients in preventing or
managing heart disease is by recognizing and treating depression, a condition that can harm the
heart and make a heart patient’s recovery more difficult. (HEALTH PLAN) is providing a
screening tool, practice guideline and patient education materials to support your work.
People with heart disease are more likely to suffer from depression than otherwise healthy people;
conversely, people with depression are at greater risk for developing heart disease.1 Depression
may affect heart rhythms, increase blood pressure and alter blood clotting. It can lead to elevated
insulin and cholesterol levels. These risk factors, with obesity, form a group of signs and
symptoms that often serve as both a predictor of and a response to heart disease. Furthermore,
depression may result in chronically elevated levels of stress hormones, such as cortisol and
adrenaline, diverting the body's resources from the type of tissue repair needed in heart disease.2
Members, especially those experiencing chronic disease, often turn to their PCP for behavioral
care, and depression may be present in up to 30 percent of a PCP’s patient caseloads.3 However,
it can be challenging to diagnose and treat depression, as symptoms of depression may overlap
with those of heart disease and other physical illnesses.
For these reasons, (HEALTH PLAN) recommends that you screen all patients for depression
using the “Patient Health Questionnaire - PHQ-9” screening instrument. This tool was developed
by Pfizer Inc. and permission is granted for use in clinical settings:
www.pfizer.com/pfizer/do/mn_health.jsp. When indicated, patients can be referred to a
ValueOptions network provider for more intensive screening and treatment.
When treating depression, we recommend that you refer to the American Psychiatric
Association’s “Practice Guideline for the Treatment of Patients With Major Depressive
Disorder.” This treatment guideline can be found on the APA’s Web site:
http://www.psych.org/psych_pract/treatg/pg/Depression2e.book.cfm.
In addition, behavioral health specialists are available for consultation on individual cases or to
answer general questions via the ValueOptions PCP Behavioral Health Consultation Line, which
can be reached at XXX-XXX-XXXX.
Finally, an extensive library of patient education materials regarding behavioral health issues, as
well as issues of daily living, are available for your use at www.achievesolutions.net/providers.
We appreciate your recognition of the strong relationship between heart disease and mental
health, and for your ongoing commitment to promoting the physical and mental health and wellbeing of our membership.
Sincerely,
(Plan executive)
1
Nemeroff CB, Musselman DL, Evans DL. Depression and cardiac disease. Depression and Anxiety, 1998; 8(Suppl 1): 71-9.
“Depression and Heart Disease,” National Institute of Mental Health.
3
Lemelin, J., Hotz, S., Swensen, R., et al. (1994). Depression in primary care: why do we miss the diagnosis? Can Family Physician,
40:104-108.
2