Blended Collaborative Care for Heart Failure and Co-Morbid Depression
Heart Failure, Systolic, Depression, Cardiovascular Disease
About this trial
This is an interventional treatment trial for Heart Failure, Systolic focused on measuring Heart Failure, Systolic, Depressive Disorder, Depressive Disorder, Major, Mood Disorder
Eligibility Criteria
Inclusion Criteria:
- Systolic heart failure (documented ejection fraction ≤ 40%).
- HF symptoms meeting criteria for New York Heart Association (NYHA) classes II, III or IV.
- Inpatient two-item Patient Health Questionnaire (PHQ-2) screen-positive for depression; or PHQ-2 screen negative for depression and PHQ-9 <5 if non-depressed control.
- PHQ-9 ≥ 10 when reassessed two-weeks following hospital discharge, or PHQ-9 <5 if non-depressed control.
- No cognitive impairment (as documented in the record, use of donepezil or similar medications for treating cognitive impairment, or the Montreal Cognitive Assessment).
- Able to be evaluated and treated for depression as an outpatient.
- English speaking, not illiterate, or possessing any other communication barrier.
- Have a household telephone.
Exclusion Criteria:
- Receiving active treatment for a mood or anxiety disorder from a mental health specialist.
- Unstable medical condition as indicated by history, physical, and/or laboratory findings.
- Presence of non-cardiovascular conditions likely to be fatal within 12 months (e.g., cancer).
- Organic mood syndromes, including those secondary to medical illness or drugs.
- Active suicidal ideation.
- Current or history of psychotic illness.
- Current or history of bipolar illness according to patient self-report, past medical history, and diagnostic criteria.
- Current alcohol or other substance abuse as evidenced by chart review and the AUDIT-C questionnaire.
- Age ≤ 21 years.
Sites / Locations
- University of Pittsburgh
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Active Comparator
Active Comparator
No Intervention
No Intervention
Collaborative Care for Heart Failure + Depression
Collaborative Care for Heart Failure Only
Usual Care for Heart Failure and Depression
Non-Depressed Comparison Cohort
Collaborative care program for heart failure and depression involving a nurse care manager providing counseling and treatment advice via telephone Interventions: Behavioral: Counseling for heart failure self-care Counseling for depression Drug: Pharmacotherapy for heart failure Pharmacotherapy for depression
Collaborative care program for heart failure and depression involving a nurse care manager providing counseling and treatment advice via telephone Interventions: Behavioral: Counseling for heart failure self-care Usual care for depression Drug: Pharmacotherapy for heart failure Usual Care for depression
Control group will receive their doctors' usual care for heart failure and depression
Control group will receive their doctors' usual care for heart failure