A telephone-delivered nursing care strategy that combined heart failure care management with depression treatment – referred to as “blended” care – improved patients’ clinical outcomes, according to the formal, final results of the Hopeful Heart Trial.
In the trial, researchers randomized 629 participants with depression to one of three treatment options: blended care for both heart failure and depression; collaborative care for heart failure only, or physicians’ usual care. Researchers included another 127 participants without depression to facilitate further comparisons. Nurses trained to administer depression care had weekly care-review conference calls with a study psychiatrist and cardiologist. Then they relayed treatment recommendations to patients and their primary care physicians. Afterward, nurses monitored patients via regular telephone calls and made recommendations for adjustments in care depending on patients’ responses to treatment.
At 12-months follow-up, ‘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.
The researchers hope that this innovative and practical approach to patient care could be implemented more broadly, especially as both patients and health care workers have become more accustomed to telemedicine than ever before. The study, funded by NHLBI, appears in JAMA Internal Medicine.