ACC 2019—Blended care for depression and HF boosts QoL


  • Caleb Rans, PharmD
  • Conference Reports
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Takeaway

  • In patients with comorbid depression and heart failure (HF), a blended collaborative care model improved health-related QoL (HRQoL) and reduced mood symptoms better than usual care in the Hopeful Heart study.    

Why this matters

  • Depression in patients with HF highly underdiagnosed and undertreated.

Study design

  • The blended care model included weekly team meetings with a psychiatrist, cardiologist, internist, and nurses; the collaborative model included a cardiologist, internist, and nurses.
  • A care manager telephoned each patient every 2 weeks to evaluate care and monitor treatment response.
  • 629 patients with comorbid depression and HF were followed for 12 months.
  • Outcomes were assessed using the Mental Component of the Short-Form 12 Health Survey (SF-12 MCS) and PROMIS Depression scales.

Key results

  • The blended care model improved HRQoL (effect size [ES], 0.34; P=.002) and decreased mood symptoms (ES, 0.47; P<.0001 better than usual care after months of follow-up.>
  • The blended care model decreased mood symptoms more than collaborative care alone (ES, 0.24; P=.006) after 12 months of follow-up.

Limitations

  • Single-site study.
  • Health information privacy concerns (HIPPA).

 Expert comment

  • "Depression is highly comorbid with HF and associated with worse self-reported function and HRQoL. More effective treatments for depression are needed," said Bruce Rollman, MD, MPH, professor of medicine at the University of Pittsburgh Medical Center, Pittsburgh. He was not a participant in the trial.