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Blended Collaborative Care for Patients With Heart Failure and Comorbid Depression Showed Quality-of-Life Improvement
Blended collaborative care for patients with heart failure and comorbid depression showed improvements over patients who were for treated heart failure only, according to new research published in JAMA Internal Medicine.
“Depression is often comorbid in patients with heart failure and is associated with worse clinical outcomes. However, depression generally goes unrecognized and untreated in this population,” wrote Bruce L Rollman, MD, MPH, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, and co-researchers.
Researchers aimed to determine if treating both depression and heart failure simultaneously in a blended collaborative care program could improve clinical outcomes for patients.
A total of 736 patients with heart failure with reduced left ventricular fraction were included in this single-blind, 3-arm, randomized effectiveness trial. All participants were recruited between March 2014 and October 2017 from 8 university and community hospitals in southwestern Pennsylvania. Patients were observed until November 2018 and analyses were completed between November 2018 to March 2019.
A total of 629 participants screened positive for depression. The remaining 127 participants were used for further comparison.
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Patients received either 1 year of collaborative care for heart failure and depression, collaborative care (enhanced usual care) for heart failure only, or physicians’ usual care.
Blended care receiving participants reported a 4.47 point improvement of mental health-related quality-of life as measured by the Mental Component Summary of the 12-item Short Form Health Survey, in addition to a better mood when compared to heart failure patients receiving usual care.
The collaborative care treatment arm and blended care treatment arm reported similar improvements to mental health quality-of life, while the blended care treatment arm reported better mood.
All treatment arms reported similar physical function, health failure pharmacotherapy use, rehospitalizations, and mortality rates.
“Although blended care did not differentially affect rehospitalization and mortality, it improved mood better than eUC [enhanced usual care] and UC [usual care] and thus may enable organized health care systems to provide effective first-line depression care to medically complex patients,” concluded Dr Rollman et al.
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