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 - the ESCAPE consortium

N1 - Publisher Copyright: © 2023 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

PY - 2023

Y1 - 2023

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

U2 - 10.1002/ehf2.14294

DO - 10.1002/ehf2.14294

M3 - Journal article

C2 - 36907651

AN - SCOPUS:85150601287

VL - 10

SP - 2051

EP - 2065

JO - E S C Heart Failure

JF - E S C Heart Failure

SN - 2055-5822

IS - 3

ER -