Universität zu Köln

Herrmann-Lingen, Christoph, Albus, Christian, de Zwaan, Martina, Geiser, Franziska, Heinemann, Katrin, Hellmich, Martin, Michal, Matthias, Sadlonova, Monika, Tostmann, Ralf, Wachter, Rolf and Belnap, Birgit Herbeck (2020). Efficacy of team-based collaborative care for distressed patients in secondary prevention of chronic coronary heart disease (TEACH): study protocol of a multicenter randomized controlled trial. BMC Cardiovasc. Disord., 20 (1). LONDON: BMC. ISSN 1471-2261

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Abstract

Background: Coronary heart disease (CHD) is the leading cause of death and years of life lost worldwide. While effective treatments are available for both acute and chronic disease stages there are unmet needs for effective interventions to support patients in health behaviors required for secondary prevention. Psychosocial distress is a common comorbidity in patients with CHD and associated with substantially reduced health-related quality of life (HRQoL), poor health behavior, and low treatment adherence. Methods: In a confirmatory, randomized, controlled, two-arm parallel group, multicenter behavioral intervention trial we will randomize 440 distressed CHD patients with at least one insufficiently controlled cardiac risk factor to either their physicians' usual care (UC) or UC plus 12-months of blended collaborative care (TeamCare = TC). Trained nurse care managers (NCM) will proactively support patients to identify individual sources of distress and risk behaviors, establish a stepwise treatment plan to improve self-help and healthy behavior, and actively monitor adherence and progress. Additional e-health resources are available to patients and their families. Intervention fidelity is ensured by a treatment manual, an electronic patient registry, and a specialist team regularly supervising NCM via videoconferences and recommending protocol and guideline-compliant treatment adjustments as indicated. Recommendations will be shared with patients and their physicians who remain in charge of patients' care. Since HRQoL is a recommended outcome by both, several guidelines and patient preference we chose a >= 50% improvement over baseline on the HeartQoL questionnaire at 12 months as primary outcome. Our primary hypothesis is that significantly more patients receiving TC will meet the primary outcome criterion compared to the UC group. Secondary hypotheses will evaluate improvements in risk factors, psychosocial variables, health care utilization, and durability of intervention effects over 18-30 months of follow-up. Discussion: TEACH is the first study of a blended collaborative care intervention simultaneously addressing distress and medical CHD risk factors conducted in cardiac patients in a European health care setting. If proven effective, its results can improve long-term chronic care of this vulnerable patient group and may be adapted for patients with other chronic conditions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herrmann-Lingen, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Albus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED de Zwaan, Martina UNSPECIFIED UNSPECIFIED UNSPECIFIED Geiser, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinemann, Katrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hellmich, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Michal, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Sadlonova, Monika UNSPECIFIED UNSPECIFIED UNSPECIFIED Tostmann, Ralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Wachter, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Belnap, Birgit Herbeck UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-308350
DOI:	10.1186/s12872-020-01810-9
Journal or Publication Title:	BMC Cardiovasc. Disord.
Volume:	20
Number:	1
Date:	2020
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	1471-2261
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-LIFE; PERCEIVED STRESS; HOSPITAL ANXIETY; DEPRESSIVE SYMPTOMS; ARTERY-DISEASE; QUESTIONNAIRE; SCALE; RELIABILITY; VALIDATION; VALIDITY Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/30835