Feasibility and Acceptability of a Collaborative Care Intervention To Improve Symptoms and Quality of Life in Chronic Heart Failure: Mixed Methods Pilot Trial

  • Bekelman D
  • Hooker S
  • Nowels C
 et al. 
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Abstract

Background: People with chronic heart failure (HF) suffer from numerous symptoms that worsen quality of life. The CASA (Collaborative are to lleviate ymptoms and djust to Illness) intervention was designed to improve symptoms and quality of life by integrating palliative and psychosocial care into chronic care. Objective: Our aim was to determine the feasibility and acceptability of CASA and identify necessary improvements. Methods: We conducted a prospective mixed-methods pilot trial. The CASA intervention included (1) nurse phone visits involving structured symptom assessments and guidelines to alleviate breathlessness, fatigue, pain, or depression; (2) structured phone counseling targeting adjustment to illness and depression if present; and (3) weekly team meetings with a palliative care specialist, cardiologist, and primary care physician focused on medical recommendations to primary care providers (PCPs, physician or nurse practioners) to improve symptoms. Study subjects were outpatients with chronic HF from a Veteran's Affairs hospital ( n=15) and a university hospital ( n=2). Measurements included feasibility (cohort retention rate, medical recommendation implementation rate, missing data, quality of care) and acceptability (an end-of-study semi-structured participant interview). Results: Participants were male with a median age of 63 years. One withdrew early and there were

Author-supplied keywords

  • Aged
  • Chronic Disease -- Psychosocial Factors
  • Coding
  • Data Analysis Software
  • Descriptive Statistics
  • Funding Source
  • Heart Failure -- Therapy
  • Human
  • Interview Guides
  • Male
  • Middle Age
  • Multidisciplinary Care Team -- Methods
  • Multimethod Studies
  • Pilot Studies
  • Prospective Studies
  • Quality of Life
  • Questionnaires
  • Support, Psychosocial

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  • PMID: 2012469694

Authors

  • David B Bekelman

  • Stephanie Hooker

  • Carolyn T Nowels

  • Deborah S Main

  • Paula Meek

  • Connor McBryde

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