Importance: Heart failure (HF) has a major effect on patients' health status, including their symptom burden, functional status, and health-related quality of life.
Objective: To determine the effectiveness of a collaborative care patient-centered disease management (PCDM) intervention to improve the health status of patients with HF.
Design, Settings & Participants: The Patient-Centered Disease Management (PCDM) trial was a multisite randomized clinical trial comparing a collaborative care PCDM intervention with usual care in patients with HF. A population-based sample of 392 patients with an HF diagnosis from 4 Veterans Affairs centers who had a Kansas City Cardiomyopathy Questionnaire (KCCQ) overall summary score of less than 60 (heavy symptom burden and impaired functional status and quality of life) were enrolled between May 2009 and June 2011.
Interventions: The PCDM intervention included collaborative care by a multidisciplinary care team consisting of a nurse coordinator, cardiologist, psychiatrist, and primary care physician; home telemonitoring and patient self-management support; and screening and treatment for comorbid depression.
Main Outcomes & Measures: The primary outcome was change in the KCCQ overall summary score at 1 year (a 5-point change is clinically significant). Mortality, depression, anxiety, and other common heart failure symptoms were also measured at baseline, 3, 6, and 12 months.
Study protocol, study grant
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