Depressed veterans with heart disease face financial barriers to care

April 3, 2017, American Heart Association

Veterans with heart disease who are also depressed are more likely than those without depression to have trouble paying for medications and medical visits and often report delays in seeking medical care, according to research presented at the American Heart Association's Quality of Care and Outcomes Research 2017 Scientific Sessions.

Data from the Centers for Disease Control and Prevention's 2013 Behavioral Risk Factor Surveillance System survey was used to study 13,126 veterans who reported being told that they had a heart attack, stroke, or angina or coronary by a health professional.

Of those studied, 22 percent reported having been diagnosed with depression. Veteran heart patients with depression were more likely to be older and non-white, and were less likely to be employed, own a home, and had lower annual income.

They had higher rate of high blood pressure, elevated cholesterol, chronic (a lung disease that causes breathing difficulty), , asthma, smoking, obesity and lack of physical inactivity.

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.

Data about the veteran participants in this study came from the participants' own responses, rather than from medical records. The survey did not discern whether the veterans received care at Department of Veterans Affairs (VA) facilities or other non-VA facilities.

"All who treat veterans with depression should routinely ask their patients about any difficulty with being able to pay for or medications," said the study's senior author, 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 some cases, less expensive medications can be considered and 90-day supply of drugs can be prescribed instead of a 30-day supply which 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."

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

"Further, VA-based research could shed more light on how mental illness affects heart disease care for veterans," Parikh said. Also, future national surveys could include other mental health diagnoses that impact veterans, such as post-traumatic stress disorder (PTSD), she said.

Explore further: Women veterans younger, more depressed when referred for heart test

Related Stories

Women veterans younger, more depressed when referred for heart test

February 27, 2015
Women veterans who had specialized heart tests were younger and more likely to be obese, depressed and suffer from post-traumatic stress disorder than men veterans, according to a study published in an American Heart Association ...

PTSD may affect blood vessel health in veterans

March 23, 2016
Post-traumatic stress disorder (PTSD) may decrease the ability of blood vessels to dilate, raising the risk of heart attack and stroke in veterans, according to new research in the Journal of the American Heart Association.

Transgender veterans have high rates of mental health problems

April 1, 2016
Among military veterans identifying as transgender, 90 percent have at least one mental health diagnosis, such as posttraumatic stress disorder (PTSD) or depression, and nearly 50 percent had a hospitalization after a suicide ...

Poorer heart attack victims, especially women, fare worse: study

October 28, 2016
(HealthDay)—Younger heart attack survivors who struggle to afford health care and medications have worse outcomes than those who don't, a new study finds.

VA puts latest estimate of veteran suicides at 20 per day

July 7, 2016
On average, 20 veterans a day committed suicide in 2014, a slight decrease from the previous government estimate, but federal health officials are cautious about concluding the suicide problem is getting better.

Veterans more likely to delay seeking health care—possible link to long wait times for VA care

May 2, 2016
Military veterans are more likely to report delays in seeking necessary healthcare, compared to the US general population, reports a study in the Journal of Public Health Management and Practice. The journal is published ...

Recommended for you

Beetroot juice supplements may help certain heart failure patients

February 22, 2018
Beetroot juice supplements may help enhance exercise capacity in patients with heart failure, according to a new proof-of-concept study. Exercise capacity is a key factor linked to these patients' quality of life and even ...

Heart researchers develop a new, promising imaging technique for cardiac arrhythmias

February 22, 2018
Every five minutes in Germany alone, a person dies of sudden cardiac arrest or fibrillation, the most common cause of death worldwide. This is partly due to the fact that doctors still do not fully understand exactly what ...

Sweet, bitter, fat: New study reveals impact of genetics on how kids snack

February 22, 2018
Whether your child asks for crackers, cookies or veggies to snack on could be linked to genetics, according to new findings from the Guelph Family Health Study at the University of Guelph.

Scientists use color-coded tags to discover how heart cells develop

February 22, 2018
UCLA researchers used fluorescent colored proteins to trace how cardiomyocytes—cells in heart muscle that enable it to pump blood—are produced in mouse embryos. The findings could eventually lead to methods for regenerating ...

The good and bad health news about your exercise posts on social media

February 22, 2018
We all have that Facebook friend—or 10—who regularly posts photos of his or her fitness pursuits: on the elliptical at the gym, hiking through the wilderness, crossing a 10K finish line.

'Beetroot pill' could help save patients from kidney failure after heart X-ray

February 22, 2018
Beetroot may reduce the risk of kidney failure in patients having a heart x-ray, according to research led by Queen Mary University of London.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.