Study Finds Integrated Treatment for Depression, Heart Failure Improves Quality of Life and Mood

A recent clinical trial found that a telephone-delivered nursing care strategy that combined heart failure care management with depression treatment improved patients’ clinical outcomes, according to a University of Pittsburgh press release.

The Hopeful Heart trial involved a first of its kind “blended” collaborative care model for treating heart failure and depression. Under the blended model, medical nurses were trained to deliver depression and heart failure care under guidance of a study cardiologist, psychiatrist, and primary care physician.

“Heart failure is one of the most common cardiovascular diseases in the United States, and it’s growing even more prevalent as the population ages,” said lead author Bruce Rollman, MD, MPH, UPMC endowed chair and professor of medicine at Pitt, in the press release. “I’m very excited about our results because they show that we can successfully train medical nurses to deliver effective depression care as part of heart failure care management they may already be delivering, and that this pragmatic approach can significantly improve patients’ mood and help them regain a better quality of life.”

Few studies have examined the benefits of depression treatment on the recovery of heart failure patients, which prompted the researchers to test a telephone-delivered blended model of collaborative care. Medical nurses trained in depression care had weekly care-review conference calls with a study psychiatrist and a study cardiologist, after which they relayed treatment recommendations to patients and their primary care physicians.

The study nurses then monitored patients via regular telephone calls and made recommendations for adjustments in care depending on the patients’ responses to treatment.

“Collaborative ‘blended’ care model provides extra layers of emotional and educational support for patients and their families,” said co-author Amy Anderson, MS, clinical coordinator for the Hopeful Heart Trial at Pitt, in the press release. “When we sit in on case review sessions with doctors and nurses, we end up learning a great deal about these patients’ lives; it becomes personal. So, it is always very rewarding to see these patients overcome hurdles and improve over time.”

The trial analyzed 756 participants with heart failure from 8 Pittsburgh-area hospitals, including 629 patients who screened positive for depression. The 12-month follow-up showed that blended care patients reported better mental health-related quality of life, including fewer limitations in social activities, improved general well-being, higher energy and less fatigue, and improved mood compared to patients receiving usual care and improved mood compared to those who received collaborative care for heart failure alone, according to the study.

The research team expressed hope that this approach to patient care could be implemented more broadly, as both patients and health care workers have become more accustomed to telemedicine than ever before.

“Depression often goes unrecognized and untreated in heart failure patients, and we are encouraged that our integrated approach to addressing depression was not only effective, but that it can be easily scaled up and expanded nationally,” Rollman said in the press release. “A ‘blended’ collaborative care that is built on existing systems of care also may enable organized health care systems such as UPMC to deliver effective first-line care for depression and other mental health conditions to patients with complex medical conditions.”

REFERENCE

Integrated treatment for depression and heart failure improves quality of life and mood. UPMC. August 30, 2021. August 31, 2021. https://www.upmc.com/media/news/083021-rollman-hopeful-heart