27 Feb Collaborative Heart Failure Care Did Not Reduce Hospitalizations or Mortality, But Reduced Depression and Fatigue
MedicalResearch.com Interview with:
Dr. Bekelman
David Bekelman, MD, MPH
Associate Professor of Medicine and Nursing
Eastern Colorado Health Care System, Department of Veterans Affairs, Denver, CO
University of Colorado School of Medicine at the Anschutz Medical Campus, Aurora, CO
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Many of the 5.8 million Americans with heart failure live with bothersome symptoms, reduced function and poor quality of life. Improving their care is important because many people with heart failure live with these challenges for years.
This study evaluated the effect of a team intervention, Collaborative Care to Alleviate Symptoms and Adjust to Illness, also called CASA, on several aspects of quality of life in 314 patients with heart failure. The patients, who received care at diverse health systems in Colorado, were randomized to receive usual care or usual care supplemented with the CASA intervention, which included a nurse and a social worker who collaborated with a primary care provider, cardiologist, and palliative care physician to address the patients’ needs.
The study found that the CASA intervention did not influence the primary outcome of heart failure health status, yet did improve patients’ depression and fatigue. CASA did not influence number of patient hospitalizations or mortality.
MedicalResearch.com: What should readers take away from your report?
Response: While the study had mixed results, the improvements in depression and fatigue are important because they are both common, burdensome, and difficult to treat in heart failure. Very few other studies have found treatments for these symptoms in patients with heart failure. Furthermore, the improvement in depression lasted the whole duration of the patient’s 12-month study period, months after the CASA intervention ended.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Next steps include studying the CASA intervention in a higher-risk or more ill population, and using health technology, such as videoconference, to extend the reach of the CASA intervention. Further research is needed to test scalable ways to improve quality of life in outpatients with heart failure and other chronic serious illnesses.
Disclosures: The study was supported by funding from the National Institute of Nursing Research (NIH R01-NR013422), the Colorado Clinical and Translational Sciences Institute (UL1 TR001082), and the VA’s Health Services Research and Development Service (CDA 08-022).
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Last Updated on February 27, 2018 by Marie Benz MD FAAD