TY - JOUR
T1 - Integrated care for older multimorbid heart failure patients
T2 - protocol for the ESCAPE randomized trial and cohort study
AU - Zelenak, Christine
AU - Nagel, Jonas
AU - Bersch, Kristina
AU - Derendorf, Lisa
AU - Doyle, Frank
AU - Friede, Tim
AU - Herbeck Belnap, Birgit
AU - Kohlmann, Sebastian
AU - Skou, Søren T.
AU - Velasco, Carlos A.
AU - Albus, Christian
AU - Asendorf, Thomas
AU - Bang, Christian Axel
AU - Beresnevaite, Margarita
AU - Bruun, Niels Eske
AU - Burg, Matthew M.
AU - Buhl, Sussi Friis
AU - Gæde, Peter H.
AU - Lühmann, Dagmar
AU - Markser, Anna
AU - Nagy, Klaudia Vivien
AU - Rafanelli, Chiara
AU - Rasmussen, Sanne
AU - Søndergaard, Jens
AU - Sørensen, Jan
AU - Stauder, Adrienne
AU - Stock, Stephanie
AU - Urbinati, Stefano
AU - Riva, Diego Della
AU - Wachter, Rolf
AU - Walker, Florian
AU - Pedersen, Susanne S.
AU - Herrmann-Lingen, Christoph
AU - consortium, the ESCAPE
N1 - https://doi.org/10.1002/ehf2.14294
PY - 2023/6
Y1 - 2023/6
N2 - ESCAPE: Evaluation of a patient-centred biopsychosocial blended collaborative care pathway for the treatment of multimorbid elderly patients. Therapeutic Area: Healthcare interventions for the management of older patients with multiple morbidities. Aims: Multi-morbidity treatment is an increasing challenge for healthcare systems in ageing societies. This comprehensive cohort study with embedded randomized controlled trial tests an integrated biopsychosocial care model for multimorbid elderly patients. Hypothesis: A holistic, patient-centred pro-active 9-month intervention based on the blended collaborative care (BCC) approach and enhanced by information and communication technologies can improve health-related quality of life (HRQoL) and disease outcomes as compared with usual care at 9 months. Methods: Across six European countries, ESCAPE is recruiting patients with heart failure, mental distress/disorder plus ≥2 medical co-morbidities into an observational cohort study. Within the cohort study, 300 patients will be included in a randomized controlled assessor-blinded two-arm parallel group interventional clinical trial (RCT). In the intervention, trained care managers (CMs) regularly support patients and informal carers in managing their multiple health problems. Supervised by a clinical specialist team, CMs remotely support patients in implementing the treatment plan—customized to the patients' individual needs and preferences—into their daily lives and liaise with patients' healthcare providers. An eHealth platform with an integrated patient registry guides the intervention and helps to empower patients and informal carers. HRQoL measured with the EQ-5D-5L as primary endpoint, and secondary outcomes, that is, medical and patient-reported outcomes, healthcare costs, cost-effectiveness, and informal carer burden, will be assessed at 9 and ≥18 months. Conclusions: If proven effective, the ESCAPE BCC intervention can be implemented in routine care for older patients with multiple morbidities across the participating countries and beyond.
AB - ESCAPE: Evaluation of a patient-centred biopsychosocial blended collaborative care pathway for the treatment of multimorbid elderly patients. Therapeutic Area: Healthcare interventions for the management of older patients with multiple morbidities. Aims: Multi-morbidity treatment is an increasing challenge for healthcare systems in ageing societies. This comprehensive cohort study with embedded randomized controlled trial tests an integrated biopsychosocial care model for multimorbid elderly patients. Hypothesis: A holistic, patient-centred pro-active 9-month intervention based on the blended collaborative care (BCC) approach and enhanced by information and communication technologies can improve health-related quality of life (HRQoL) and disease outcomes as compared with usual care at 9 months. Methods: Across six European countries, ESCAPE is recruiting patients with heart failure, mental distress/disorder plus ≥2 medical co-morbidities into an observational cohort study. Within the cohort study, 300 patients will be included in a randomized controlled assessor-blinded two-arm parallel group interventional clinical trial (RCT). In the intervention, trained care managers (CMs) regularly support patients and informal carers in managing their multiple health problems. Supervised by a clinical specialist team, CMs remotely support patients in implementing the treatment plan—customized to the patients' individual needs and preferences—into their daily lives and liaise with patients' healthcare providers. An eHealth platform with an integrated patient registry guides the intervention and helps to empower patients and informal carers. HRQoL measured with the EQ-5D-5L as primary endpoint, and secondary outcomes, that is, medical and patient-reported outcomes, healthcare costs, cost-effectiveness, and informal carer burden, will be assessed at 9 and ≥18 months. Conclusions: If proven effective, the ESCAPE BCC intervention can be implemented in routine care for older patients with multiple morbidities across the participating countries and beyond.
KW - Blended collaborative care
KW - Depression
KW - Heart failure
KW - Multi-morbidity
KW - Multinational trial
KW - Psychological distress
KW - Quality of life
KW - Delivery of Health Care, Integrated
KW - Humans
KW - Treatment Outcome
KW - Multimorbidity
KW - Randomized Controlled Trials as Topic
KW - Observational Studies as Topic
KW - Quality of Life
KW - Aged
KW - Heart Failure/therapy
KW - Cohort Studies
U2 - 10.1002/ehf2.14294
DO - 10.1002/ehf2.14294
M3 - Journal article
C2 - 36907651
SN - 2055-5822
VL - 10
SP - 2051
EP - 2065
JO - E S C Heart Failure
JF - E S C Heart Failure
IS - 3
ER -