Supportive care improves psychological condition in patients with HF

Abstract Previous studies and RCTs emphasized the challenge to improve the emotional/psychological health of patients with heart failure further the physical impairment since neurohormonal changes affect mental health as well. The aim of the current multicenter RCT was to evaluate the effectiveness of an individualized SUPPORTive care multidisciplinary management program in patients with HEART failure to improve patients’ health related quality of life (HR-QoL)(Minnesota Living with Heart Failure questionnaire’ -MLHFQ) and possible anxiety and depression (HADS questionnaire) compared to the ‘usual’ care. The RCT named ‘SupportHeart’ (Trial ID: NCT04415723) followed pragmatic methodology. It was consisted by two groups: 1. The intervention group (IG) and 2. The control group (CG). The study investigated the patients with HF for a period of one year at 5 time points (in baseline, 1 month, 3 months, 6 months, 1 year). Comparisons between IG and CG at each time point were assessed using a Welsch t-test. Comparisons of lost to follow- up between the two groups was assessed using the Fisher’s exact test. For the effect of the intervention on the Scales’ scores (MLHFQ, HADS) Linear Mixed Models Effects (LMME) were performed with the level of the scale as the dependent variable, and independent variables the group (CG, IG), the time-point (baseline, 1 month, 3 months, 6 months, 1 year) and the interaction between group and time-point (Group X Time). Results Two hundred two patients participated in the study with an overall mean age of 71.8 (SD = 10.9) years old. The 65 of them (32%) were women. LMME results have shown that there is a statistically significant effect of the Intervention on the Physical dimension at 1 month after the intervention (p = 0.022) and on the Emotional dimension, at 1 month (p = 0.004) and 3 months (p = 0.037) after the intervention (Graph 1). At 3 months, 6 months and 1 year, IG had lower Emotional Distress compared to CG (p < 0.001)(Graph2). Conclusion SupportHeart program confirms the effectiveness of continuing support by a nurse-led multidisciplinary team in the HR-QoL and especially the psychological condition. Pragmatic methodology provides the opportunity for individualized care in any health care system and a challenging environment using all available sources each time.