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

Research output: Contribution to journalJournal articleResearchpeer-review

  • Johan S. Bundgaard
  • Mia Pries-Heje
  • Nikolaj Ihlemann
  • Theis S. Bak
  • Lauge Østergaard
  • Sabine U. Gill
  • Trine Madsen
  • Hanne Elming
  • Kaare T. Jensen
  • Kurt Fuursted
  • Martin Schultz
  • Flemming Rosenvinge
  • Henrik C. Schønheyder
  • Jannik Helweg-Larsen
  • Christian Torp-Pedersen
  • Emil L. Fosbøl
  • Niels Tønder
  • Ulrik M. Mogensen

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.

Original languageEnglish
Article number110718
JournalJournal of Psychosomatic Research
Volume154
ISSN0022-3999
DOIs
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Inc.

    Research areas

  • Antibiotic, Anxiety, Cardiovascular disease, Depression, Endocarditis

ID: 291221405