1. What is the decision or change (e.g., clinical topic, practice guideline, system design, delivery of care) you are facing or struggling with where a summary of the evidence would be helpful?
Cardiovascular disease is the leading cause of morbidity and mortality among men and women in the U.S. Ample evidence underscores the role of behavioral health - including lifestyle and psychological factors - in cardiovascular risk, and thus, the value of addressing behavioral health for secondary cardiovascular prevention. By some estimates, more than 50% of adults with a cardiovascular condition suffer from depression, anxiety, and poor quality of life, while many more struggle with behavioral risk factors such as smoking, poor diet, and nonadherence to treatment. Integrated care models are indispensable for managing chronic disease at large, but we lack comprehensive information about integrated evidence-based models in cardiovascular behavioral medicine, which will aid the adoption of these approaches to cardiovascular care.
Research Questions: What are the best practices for integration of behavioral medicine approaches (e.g., intensive behavioral counseling) to address cardiovascular disease in primary care and specialty medicine settings? What are the physical, psychological, and behavioral outcomes associated with the adoption of integrated cardiovascular care?
Population: Adults with cardiovascular diseases seeking treatment.
Intervention: Behavioral medicine approaches (mental health, behavioral health, lifestyle, [intensive] behavioral counseling, cognitive behavioral therapy).
Outcomes: Change in mental health factors (e.g., anxiety, depression, stress), quality of life, lifestyle/behavioral factors (e.g., treatment adherence, diet, exercise), rehospitalization, cardiovascular and related morbidity, and mortality.
Setting: Ambulatory, inpatient
2. Why are you struggling with this issue?
While there are numerous potential benefits of behavioral medicine for patients and providers, the integration of behavioral medicine in cardiovascular care has been slow. Where strides have been made, there is a significant variation in (1) the settings where behavioral health providers are practicing, (2) the services they provide (e.g., secondary prevention-focused cardiovascular risk counseling, comprehensive evaluations before and/or after routine cardiovascular procedures, targeted goal-setting with cardiac rehabilitation teams), and (3) the types of providers offering those services (e.g., psychologists, social workers, registered dieticians, nurses). Emerging research indicates some success in the integration of behavioral medicine into primary care and specialty practice settings, such as behavioral oncology. Despite the high rates of cardiovascular disease, and the impact of cardiovascular disease on functional status, quality of life, and lifespan, efforts to integrate behavioral medicine into cardiovascular care have not gained traction.
3. What do you want to see changed? How will you know that your issue is improving or has been addressed?
We aim to promote greater integration of, and access to, behavioral medicine and intensive behavioral counseling for patients at-risk for and with cardiovascular diseases, specifically, within ambulatory cardiology clinics, inpatient cardiology, and cardiac surgery services for the purpose of enhancing quality of cardiovascular care.
4. When do you need the evidence report?
Tue, 12/31/2024
5. What will you do with the evidence report?
The report will be shared with affiliates at the American Heart Association, American College of Cardiology, American Society for Preventive Cardiology, American Association of Cardiovascular and Pulmonary Rehabilitation, and the American College of Lifestyle Medicine, as well as other biomedical and behavioral medicine organizations, to increase buy-in for and adoption of integrated care models. We believe this report will be critical to promote the provision of integrated care to address behavioral health concerns in the context of cardiovascular conditions and can provide clinics and institutions with a clearer pathway for integrating behavioral medicine services into cardiovascular care. Finally, the report will be used by professional organizations to better delineate implementation science research agendas and guidelines for the integration of behavioral medicine practices into cardiovascular care.
Supporting Documentation
Health Psychology (PDF, 1 MB)
Optional Information About You
What is your role or perspective? Professional Society
If you are you making a suggestion on behalf of an organization, please state the name of the organization - Society of Behavioral Medicine
May we contact you if we have questions about your nomination? Yes
