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Invited Commentary
August 30, 2021

Moving Toward Fully Blended Collaborative Care: Integrating Medical and Social Care

Author Affiliations
  • 1Indiana University Center for Aging Research, Indianapolis
  • 2Sandra Eskenazi Center for Brain Care Innovation, Eskenazi Health, Indianapolis, Indiana
  • 3Regenstrief Institute, Inc, Indianapolis, Indiana
JAMA Intern Med. 2021;181(10):1380-1382. doi:10.1001/jamainternmed.2021.4993

In this issue of JAMA Internal Medicine, Rollman and colleagues1 report findings from a randomized clinical trial exploring the effectiveness of blended collaborative care for patients with heart failure and depression. The Hopeful Heart Trial demonstrates many strengths in clinical trial design and execution. First, the team included 3 control arms, including a group receiving collaborative care for heart failure alone. Second, the team enrolled a large sample of participants recently hospitalized for heart failure and still meeting criteria for depression postdischarge. Third, investigators enrolled participants from 8 different hospitals with stratification by enrollment site and sex. Fourth, nurse care managers and case conference teams did not cross study groups. Fifth, interviewers blinded to treatment assignment achieved excellent outcome assessment rates. Thus, the study offers strong internal validity and represents an impressive research implementation effort. The study also considered future scalability and financial sustainability by using a telephone-based intervention and by deferring final treatment decisions to the patient’s clinical team.

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