Clinical Edge

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Collaborative Care vs Usual Care in Heart Failure

JAMA Intern Med; ePub 2018 Feb 26; Bekelman, et al

Among patients with chronic heart failure (HF), a symptom and psychosocial collaborative care intervention was not significantly better than usual care for improving HF–specific health status, a recent study found. In the single-blind, 2-arm, multisite randomized clinical trial, 314 patients were randomized to receive the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) intervention or usual care. The CASA intervention included collaborative symptom care provided by a nurse and psychosocial care provided by a social worker, both of whom worked with the patients’ primary care clinicians and were supervised by a study primary care clinician, cardiologist, and palliative care physician. Researchers found:

  • The primary outcome of HF–specific health status did not change with the intervention.
  • Among secondary outcomes, depressive symptoms and fatigue improved with the intervention, but pain and shortness of breath did not.
  • Mortality at 12 months was similar in both arms.

Citation:

Bekelman DB, Allen LA, McBryde CF, et al. Effect of a collaborative care intervention vs usual care on health status of patients with chronic heart failure. The CASA randomized clinical trial. [Published online ahead of print February 26, 2018]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.8667.

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