The impact of antidepressants on depressive symptom severity, quality of life, morbidity, and mortality in heart failure: a systematic review

Background: Νon-pharmacological management programs for patients with chronic disease severe Heart Failure (HF) syndrome which programs are managed by nurses with interventions that promote self-care, self-management, self-maintenance, empowerment, behavior modification, have shown encouraging results the reduction of re-admissions, hospitalization days and positive results such as the reduction of hospital costs of the provided health care the costs of the Health Care System. The purpose of this Systematic Review (SR) is to examine all recent prospective studies that evaluate the impact of Non-Pharmacological Management Programs by Healthcare Professionals - Nurses in the Health Related Quality of Life (HRQofL) of HF Patients. Material and Method: After searching for published studies in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Library a total of 30 studies were found to meet the inclusion criteria in this review of which 6 systematic reviews, 15 randomized controlled trials, 4 randomized pilot studies, 2 experimental studies and 3 prospective studies. Results: Nursing education and non-pharmacological management programs for patients with HF seem to be successful and effective in improving the self-care and autonomy of patients with HF but no correlation was observed with the improvement of HRQofL. Conclusions: Further prospective studies are needed to evaluate the results of Non-Pharmacological Nursing Management of patients with HF in relation to follow-up time in the sample homogeneity, intensity and type of program to identify the most effective interventions to improve quality of life.

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Personalized treatments for depressive symptoms in patients with advanced heart failure: A pragmatic randomized controlled trial

PLoS ONE ◽

10.1371/journal.pone.0244453 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244453

Author(s):

Waguih William IsHak ◽

Samuel Korouri ◽

Tarneem Darwish ◽

Brigitte Vanle ◽

Jonathan Dang ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Depressive Symptoms ◽

Caregiver Burden ◽

Medical Center ◽

Advanced Heart Failure ◽

Morbidity And Mortality ◽

The Impact

Objectives Heart Failure is a chronic syndrome affecting over 5.7 million in the US and 26 million adults worldwide with nearly 50% experiencing depressive symptoms. The objective of the study is to compare the effects of two evidence-based treatment options for adult patients with depression and advanced heart failure, on depressive symptom severity, physical and mental health related quality of life (HRQoL), heart-failure specific quality of life, caregiver burden, morbidity, and mortality at 3, 6 and 12-months. Methods Trial design. Pragmatic, randomized, comparative effectiveness trial. Interventions. The treatment interventions are: (1) Behavioral Activation (BA), a patient-centered psychotherapy which emphasizes engagement in enjoyable and valued personalized activities as selected by the patient; or (2) Antidepressant Medication Management administered using the collaborative care model (MEDS). Participants. Adults aged 18 and over with advanced heart failure (defined as New York Heart Association (NYHA) Class II, III, and IV) and depression (defined as a score of 10 or above on the PHQ-9 and confirmed by the MINI International Neuropsychiatric Interview for the DSM-5) selected from all patients at Cedars-Sinai Medical Center who are admitted with heart failure and all patients presenting to the outpatient programs of the Smidt Heart Institute at Cedars-Sinai Medical Center. We plan to randomize 416 patients to BA or MEDS, with an estimated 28% loss to follow-up/inability to collect follow-up data. Thus, we plan to include 150 in each group for a total of 300 participants from which data after randomization will be collected and analyzed. Conclusions The current trial is the first to compare the impact of BA and MEDS on depressive symptoms, quality of life, caregiver burden, morbidity, and mortality in patients with depression and advanced heart failure. The trial will provide novel results that will be disseminated and implemented into a wide range of current practice settings. Registration ClinicalTrials.Gov Identifier: NCT03688100.

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A Web- and Mobile-Based Intervention for Comorbid, Recurrent Depression in Patients With Chronic Back Pain on Sick Leave (Get.Back): Pilot Randomized Controlled Trial on Feasibility, User Satisfaction, and Effectiveness

JMIR Mental Health ◽

10.2196/16398 ◽

2020 ◽

Vol 7 (4) ◽

pp. e16398

Author(s):

Sandra Schlicker ◽

Harald Baumeister ◽

Claudia Buntrock ◽

Lasse Sander ◽

Sarah Paganini ◽

...

Keyword(s):

Quality Of Life ◽

Health Insurance ◽

Depressive Symptom ◽

Sick Leave ◽

Symptom Severity ◽

User Satisfaction ◽

Depressive Symptom Severity ◽

Secondary Outcomes

Background Chronic back pain (CBP) is linked to a higher prevalence and higher occurrence of major depressive disorder (MDD) and can lead to reduced quality of life. Unfortunately, individuals with both CBP and recurrent MDD are underidentified. Utilizing health care insurance data may provide a possibility to better identify this complex population. In addition, internet- and mobile-based interventions might enhance the availability of existing treatments and provide help to those highly burdened individuals. Objective This pilot randomized controlled trial investigated the feasibility of recruitment via the health records of a German health insurance company. The study also examined user satisfaction and effectiveness of a 9-week cognitive behavioral therapy and Web- and mobile-based guided self-help intervention Get.Back in CBP patients with recurrent MDD on sick leave compared with a waitlist control condition. Methods Health records from a German health insurance company were used to identify and recruit participants (N=76) via invitation letters. Study outcomes were measured using Web-based self-report assessments at baseline, posttreatment (9 weeks), and a 6-month follow-up. The primary outcome was depressive symptom severity (Center for Epidemiological Studies–Depression); secondary outcomes included anxiety (Hamilton Anxiety and Depression Scale), quality of life (Assessment of Quality of Life), pain-related variables (Oswestry Disability Index, Pain Self-Efficacy Questionnaire, and pain intensity), and negative effects (Inventory for the Assessment of Negative Effects of Psychotherapy). Results The total enrollment rate with the recruitment strategy used was 1.26% (76/6000). Participants completed 4.8 modules (SD 2.6, range 0-7) of Get.Back. The overall user satisfaction was favorable (mean Client Satisfaction Questionnaire score=24.5, SD 5.2). Covariance analyses showed a small but statistically significant reduction in depressive symptom severity in the intervention group (n=40) at posttreatment compared with the waitlist control group (n=36; F1,76=3.62, P=.03; d=0.28, 95% CI −0.17 to 0.74). Similar findings were noted for the reduction of anxiety symptoms (F1,76=10.45; P=.001; d=0.14, 95% CI −0.31 to 0.60) at posttreatment. Other secondary outcomes were nonsignificant (.06≤P≤.44). At the 6-month follow-up, the difference between the groups with regard to reduction in depressive symptom severity was no longer statistically significant (F1,76=1.50, P=.11; d=0.10, 95% CI −0.34 to 0.46). The between-group difference in anxiety at posttreatment was maintained to follow-up (F1,76=2.94, P=.04; d=0.38, 95% CI −0.07 to 0.83). There were no statistically significant differences across groups regarding other secondary outcomes at the 6-month follow-up (.08≤P≤.42). Conclusions These results suggest that participants with comorbid depression and CBP on sick leave may benefit from internet- and mobile-based interventions, as exemplified with the positive user satisfaction ratings. The recruitment strategy via health insurance letter invitations appeared feasible, but more research is needed to understand how response rates in untreated individuals with CBP and comorbid depression can be increased. Trial Registration German Clinical Trials Register DRKS00010820; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00010820.

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Long-term morbidity and mortality in patients hospitalised with systolic heart failure, and the impact of health-related quality of life

European Heart Journal ◽

10.1093/eurheartj/eht308.p1490 ◽

2013 ◽

Vol 34 (suppl 1) ◽

pp. P1490-P1490

Author(s):

J. Berg ◽

P. Lindgren ◽

T. Kahan ◽

O. Schill ◽

H. Persson ◽

...

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

Systolic Heart Failure ◽

Morbidity And Mortality ◽

Health Related Quality ◽

Related Quality ◽

Health Related ◽

The Impact

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What is the impact of depressive and anxious symptoms on quality of life in veterans with heart failure?

PsycEXTRA Dataset ◽

10.1037/e609612010-005 ◽

2010 ◽

Author(s):

J. A. Cully ◽

L. L. Phillips ◽

M. E. Kunik ◽

M. A. Stanley ◽

A. Deswal

Keyword(s):

Quality Of Life ◽

Heart Failure ◽

The Impact

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Exercise efficacy and prescription during treatment for pancreatic ductal adenocarcinoma: a systematic review

BMC Cancer ◽

10.1186/s12885-020-07733-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Dominic O’Connor ◽

Malcolm Brown ◽

Martin Eatock ◽

Richard C. Turkington ◽

Gillian Prue

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Pancreatic Cancer ◽

Adjuvant Therapy ◽

Physical Function ◽

Meta Analysis ◽

Ductal Adenocarcinoma ◽

Key Stakeholders ◽

The Impact

Abstract Background Surgical resection remains the only curative treatment for pancreatic cancer and is associated with significant post-operative morbidity and mortality. Patients eligible for surgery, increasingly receive neo-adjuvant therapy before surgery or adjuvant therapy afterward, inherently exposing them to toxicity. As such, optimizing physical function through exercise during treatment remains imperative to optimize quality of life either before surgery or during rehabilitation. However, current exercise efficacy and prescription in pancreatic cancer is unknown. Therefore, this study aims to summarise the published literature on exercise studies conducted in patients with pancreatic cancer undergoing treatment with a focus on determining the current prescription and progression patterns being used in this population. Methods A systematic review of four databases identified studies evaluating the effects of exercise on aerobic fitness, muscle strength, physical function, body composition, fatigue and quality of life in participants with pancreatic cancer undergoing treatment, published up to 24 July 2020. Two reviewers independently reviewed and appraised the methodological quality of each study. Results Twelve studies with a total of 300 participants were included. Heterogeneity of the literature prevented meta-analysis. Exercise was associated with improvements in outcomes; however, study quality was variable with the majority of studies receiving a weak rating. Conclusions High quality evidence regarding the efficacy and prescription of exercise in pancreatic cancer is lacking. Well-designed trials, which have received feedback and input from key stakeholders prior to implementation, are required to examine the impact of exercise in pancreatic cancer on key cancer related health outcomes.

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