Key result
In HF patients with low social support, coping skills training significantly improved KCCQ scores (mean change 11.2 vs -0.8) and reduced BDI-II depression scores (-8.7 vs -3.0) compared to education.
Why the study?
The study examined whether social support modifies the effects of coping skills training on depressive symptoms and health-related quality of life in patients with heart failure.
Does telephone-based coping skills training improve quality of life and reduce depression in heart failure patients, and is this effect modified by baseline social support?
RCT (n=179)
Does telephone-based coping skills training improve quality of life and reduce depression in heart failure patients, and is this effect modified by baseline social support?
Absolute Event Rate: 11.2% vs -0.8%
p-value: p=0.006
Telephone-based coping skills training substantially improves quality of life and reduces depression in heart failure patients with low baseline social support.
Supports telephone-based coping skills training for HF patients with low social support; extends evidence for targeted psychosocial interventions.
OBJECTIVE: We examined the modifying effects of social support on depressive symptoms and health-related quality of life (QoL) in patients receiving coping skills training (CST). METHOD: We considered the modifying effects of social support in the Coping Effectively with Heart Failure clinical trial, which randomized 179 heart failure (HF) patients to either 4 months of CST or usual care enhanced by HF education (HFE). CST involved training in specific coping techniques, whereas HFE involved education about HF self-management. Social support was assessed by the Enhancing Recovery in Coronary Heart Disease (ENRICHD) Social Support Inventory, QoL was assessed with the Kansas City Cardiomyopathy Questionnaire (KCCQ), and depression was assessed with the Beck Depression Inventory-II (BDI-II). RESULTS: Linear regression models revealed a significant Intervention Group × Baseline Social Support interaction for change in KCCQ total scores (p = .006) and BDI-II scores (p < .001). Participants with low social support assigned to the CST intervention showed large improvements in KCCQ scores (M = 11.2, 95% CI [5.7, 16.8]), whereas low-social-support patients assigned to the HFE controls showed no significant change (M = -0.8, 95% CI [-7.2, 5.6]). Similarly, BDI-II scores in participants with low social support in the CST group showed large reductions (M = -8.7, 95% CI [-11.3, -6.1]) compared with low-social-support HFE participants (M = -3.0, 95% CI [-6.0, -0.1]). CONCLUSIONS: HF patients with low social support benefit substantially from telephone-based CST interventions. Targeting HF patients with low social support for behavioral interventions could prove to be a cost-effective strategy for improving QoL and reducing depression. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Blumenthal et al. (2019) conducted an RCT in Heart failure (n=179). Coping skills training (CST) vs. Usual care enhanced by HF education (HFE) was evaluated on Change in KCCQ total scores (p=0.006). In HF patients with low social support, coping skills training significantly improved KCCQ scores (mean change 11.2 vs -0.8) and reduced BDI-II depression scores (-8.7 vs -3.0) compared to education.
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