Effectiveness of a telephone-delivered psycho-behavioural intervention on depression in elderly with chronic heart failure: rationale and design of a randomized controlled trial

Abstract

Background Depression is common among chronic heart failure (CHF) patients, and it is associated with significant re-hospitalization and mortality as well as lower quality of life. While psychotherapy is efficacious treatment for depression, the effect for depression among CHF is uncertain. And barriers preclude widely utility of psychotherapy among the elderly. Telephone-delivered psycho-behavioural intervention specifically focuses on depression among the elderly with CHF, and could be a promising alternative to conventional treatment. The present study was designed to prospectively investigate the effect of a telephone-delivered psycho-behavioural intervention on depression in the elderly with chronic heart failure (CHF). Method/design In this prospective, multicentre, parallel, randomized, and controlled trial, 236 participants with depression associated with CHF (New York Heart Association classes II and III) will be enrolled. The study will consist of a 12-week intensive intervention and a 24-week maintenance intervention. Eligible participants will be randomized to either the intervention arm or the control arm. During the intensive phase, participants will receive either a guided telephone psycho-behavioural intervention or regular telephone contacts from the counsellors weekly. During the maintenance phase, participants will receive either psychological behavioural support or regular telephone contacts monthly from counsellors. Depressive symptoms, cardiac outcome and quality of life will be assessed at baseline and weeks 1, 2, 4, 8, 12, 24 and 36. Participants will undergo echocardiography and the plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP) tested at baseline, weeks 12 and 36. The primary outcome is the response rate of depression, from baseline to week 12. The second outcomes include the change in cardiac function, quality of life and severity of depressive symptoms during the trial. Discussion To our knowledge, this study is the first prospective randomized trial to test the effective of the telephone-delivered psycho-behavioural intervention on depression in the elderly with CHF. The findings are expected to provide a new and evidence-based approach for depression among the elderly with CHF. Trial registration The trial was registered at www.clinicaltrials.gov (identification number: NCT03233451 ) on 28 July 2017 and updated on 18 August 2017.

Association between the nurse-led program with mental health status, quality of life, and heart failure rehospitalization in chronic heart failure patients

“…[ 8 – 10 ] Interestingly and importantly, nonpharmacological strategies have been applied to evaluate their effects on QOL and MHS in CHF populations. [ 11 – 14 ] Among these strategies, the nurse-led program has been shown to improve QOL and MHS in these populations for a short period. Specifically, in our prior study, [ 14 ] registered nurses called CHF patients after discharge inquiring their clinical condition, medication adherence, daily sodium consumption, and physical activity.…”

Relationships between Depressive Symptoms, Appetite, and Quality of Life in Heart Failure

“…Based on our findings, the presence or increased intensity of depressive symptoms should be addressed early and be considered potential antecedents of physical symptoms and impact on QoL, especially in patients dependent for ADLs. Different clinical trials are currently being conducted to determine effective medication and non-pharmacological interventions for the treatment of depressive symptoms in this population (Ishak et al, 2021; Zhang et al, 2019).…”

Correlation between symptoms of depression, attitude, and self-care in elderly with type 2 diabetes

“…The prevalence of depressive symptoms in patients with this pathology can reach a percentage higher than 40% ( 9 ) . This symptomatology can cause a negative attitude towards the disease, hindering the acceptance to follow the pharmacological recommendation, to perform glycemic control, as well as to adopt a healthy diet and practice regular physical activities ( 10 - 11 ) . Consequently, this refusal can directly interfere with the patient’s prognosis.…”