Anywhere from 40-70% of people with heart failure experience depression at the same time, but research findings from the Hopeful Heart Trial at the University of Pittsburgh show that telephone-delivered care that blends treatment for both conditions can improve mental health-related quality of life and mood symptoms more than doctors’ usual care for these conditions. Heart failure affects up to 6.6 million Americans, but co-occurring depression is often unrecognized and untreated in this group.
Researcher Bruce Rollman, MD, MPH, and his team followed 750 heart failure patients from several UPMC hospitals. Participants were randomly assigned into one of three arms: doctors’ usual care for these conditions; a nurse-provided collaborative care intervention that addressed only heart failure; or a similar, nurse-provided care intervention that addressed both depression and heart failure. The study also included a non-depressed comparison group of heart failure patients to provide a fuller picture of the impact of depression and its treatment.
At 12-months follow-up, Rollman and his team found that the blended model of care improved participants’ mental health-related quality of life and mood symptoms compared to usual care, and the blended model also improved patients’ mood symptoms significantly more than collaborative care for heart failure alone. Although the researchers’ initial analysis found that neither collaborative care method significantly reduced the rate of hospital readmissions or all-cause mortality among depressed heart failure patients, Rollman cautioned that additional analyses and longer follow-up are needed to confirm these findings.
“Overall, these results are a reminder for all clinicians, not just cardiologists, to be mindful of their patients’ mental health, as elevated depressive symptoms occurred in nearly half of all hospitalized heart failure patients and persisted in over one-third at two weeks following discharge,” said Rollman. “A quick screening or referral to a mental health professional could significantly impact that person’s well-being, especially if that patient’s cardiac symptoms are out of proportion to his or her objective disease burden.”
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