Expanded care model improves quality of life for chronic heart failure patients

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A study, published in JAMA Internal Medicine, examined an expanded care model for chronic heart failure patients that supplemented conventional cardiac therapy with a nurse and a social worker.

Researchers studied the Collaborative Care to Alleviate Symptoms and Adjust to Illness intervention, also known as CASA. The new model extended the services of a nurse and social worker to patients receiving care from the Veterans Administration, academic and safety net health systems in Colorado between August 2012 and April 2016.

The nurses and social workers collaborated with a primary care provider, cardiologist and palliative care physician. Researchers examined 314 patients for a one-year period, with 157 of them enrolled in the CASA program. The CASA intervention lasted three to four months.

The study shows that the CASA model significantly improved depression and fatigue symptoms among patients, but did not significantly change heart failure-specific health status, pain, shortness of breath or number of hospitalizations. Additionally, 10 CASA program patients died as compared to 13 standard care patients.

"Many of the 5.8 million Americans with heart failure live with bothersome symptoms, reduced function and poor quality of life" said the study's primary author David B. Bekelman, MD, of University of Colorado School of Medicine in Aurora. "Improving their care is important because many people with heart failure live with these challenges for years."

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