학술논문
Integrated care for older multimorbid heart failure patients: protocol for the ESCAPE randomized trial and cohort study.
Document Type
Academic Journal
Author
Zelenak C; Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.; Nagel J; Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.; Bersch K; Clinical Trial Unit of the University Medical Center Göttingen, Göttingen, Germany.; Derendorf L; Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany.; Doyle F; Royal College of Surgeons in Ireland, Dublin, Ireland.; Friede T; Department of Medical Statistics, University of Göttingen Medical Centre, Göttingen, Germany.; German Centre for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany.; Herbeck Belnap B; Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.; Center for Behavioral Health, Media, and Technology, Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.; Kohlmann S; Clinic for Psychosomatic Medicine and Psychotherapy, University Hospital Hamburg Eppendorf, Hamburg, Germany.; Skou ST; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Region Zealand, Slagelse, Denmark.; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.; Velasco CA; Fraunhofer Institute for Applied Information Technology FIT, Schloss Birlinghoven, Sankt Augustin, Germany.; Albus C; Faculty of Medicine and University Hospital of Cologne, Department of Psychosomatics and Psychotherapy, University of Cologne, Cologne, Germany.; Asendorf T; Clinical Trial Unit of the University Medical Center Göttingen, Göttingen, Germany.; Bang CA; Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.; Beresnevaite M; Laboratory of Clinical Cardiology, Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.; Bruun NE; Department of Cardiology, Zealand University Hospital, Roskilde, Denmark.; Clinical Institutes, Copenhagen and Aalborg Universities, Copenhagen, Denmark.; Burg MM; Yale University School of Medicine, New Haven, CT, USA.; Buhl SF; Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.; Gaede PH; Department of Cardiology and Endocrinology, Slagelse Hospital, Slagelse, Denmark.; Institute of Regional Health, University of Southern Denmark, Odense, Denmark.; Lühmann D; University Hospital Hamburg Eppendorf, Hamburg, Germany.; Markser A; Faculty of Medicine and University Hospital of Cologne, Department of Psychosomatics and Psychotherapy, University of Cologne, Cologne, Germany.; Nagy KV; Heart and Vascular Center, Semmelweis University Budapest, Budapest, Hungary.; Rafanelli C; Department of Psychology, University of Bologna, Bologna, Italy.; Rasmussen S; Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.; Søndergaard J; Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.; Sørensen J; Healthcare Outcomes Research Centre, Dublin, Ireland.; Stauder A; Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.; Stock S; Faculty of Medicine and University Hospital of Cologne, Institute of Health Economics and Clinical Epidemiology, University of Cologne, Cologne, Germany.; Urbinati S; Bellaria Hospital and University of Bologna, Bologna, Italy.; Riva DD; Bellaria Hospital and University of Bologna, Bologna, Italy.; Wachter R; University Hospital of Leipzig, Leipzig, Germany.; Walker F; Clinical Trial Unit of the University Medical Center Göttingen, Göttingen, Germany.; Pedersen SS; Department of Psychology, University of Southern Denmark, Odense, Denmark.; Department of Cardiology, Odense University Hospital, Odense, Denmark.; Herrmann-Lingen C; Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Centre, Göttingen, Germany.; German Centre for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany.
Source
Publisher: John Wiley & Sons Ltd on behalf of the European Society of Cardiology Country of Publication: England NLM ID: 101669191 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2055-5822 (Electronic) Linking ISSN: 20555822 NLM ISO Abbreviation: ESC Heart Fail Subsets: MEDLINE
Subject
Language
English
Abstract
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.
(© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
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.
(© 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)