New Heart Failure Intervention Improves Depressive Symptoms, Fatigue

The results of a recent study have indicated that the Collaborative Care to Alleviate Symptoms and Adjust to Illness (CASA) intervention for heart failure (HF) is associated with improved depression and fatigue, which are both burdensome symptoms in patients with the condition.

However, the CASA intervention was not associated with HF-specific health status.
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In the CASA randomized clinical trial, researchers evaluated 314 participants with symptomatic HF and reduced health status from August 2012 to April 2015. Participants were randomly assigned to treatment with CASA (n = 157) or usual care (n = 157).

The Kansas City Cardiomyopathy Questionnaire was used to measure heart failure-specific health status. In addition, the 7-item Generalized Anxiety Disorder Questionnaire and the General Symptom Distress scale were used to assess anxiety and symptom distress, respectively. Specific symptoms, number of hospitalizations, and mortality were also recorded.

Results indicated that, at 6 months, the mean Kansas City Cardiomyopathy Questionnaire score had improved by 5.5 groups in the CASA group vs 2.9 points in the usual care group. Depressive symptoms and fatigue had improved at 6 months with CASA vs usual care.

The researchers did not observe any significant changes in overall symptom distress, pain, shortness of breath, or number of hospitalizations, and they noted that 12-month mortality was similar in both groups.

“This multisite randomized clinical trial of the CASA intervention did not demonstrate improved heart failure–specific health status,” the researchers concluded. “Secondary outcomes of depression and fatigue, both difficult symptoms to treat in heart failure, improved.”

—Christina Vogt

Reference:

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