Health Services, Patient Engagement

Study shows mental health services key for handling heart failure

Heart failure patients reported reduced depression symptoms and better self-care after receiving behavioral therapy through telehealth services, according to a small study by AbleTo and Humana.

A study released Monday shed new light on the link between mental and physical health.

Heart failure patients that were given access to behavioral health services were better able to manage their conditions, according to the study, conducted by New York-based behavioral telehealth company AbleTo and Humana.

The small study surveyed 194 patients with minimal to moderately-severe heart disease, covered through Humana’s Medicare Advantage plan. They participated in an eight- to 10-week telehealth program offered by AbleTo, which included access to cognitive behavioral therapy and a coach to help turn those instructions into a plan.

According to the results, patients saw a marked improvement in their mental health and understanding of physician instructions.

At the beginning of the study, 47 percent of participants reported depression symptoms. Fewer than 41 percent had an adequate Self-Care of Heart Failure Index (SCHFI) score, which measures an individual’s ability to recognize symptoms, seek treatment and adhere to important health measures, such as taking medication and maintaining a low-sodium diet.

By the end of the program, participants’ depression symptoms were reduced by 52.4 percent. The number of patients with adequate self-care scores increased to 57 percent, a 16 percentage point jump. More participants also understood physician instructions, at 87 percent. Study participants were located across the U.S.

AbleTo’s chief medical officer, Dr. Reena Pande, noticed behavioral health issues were prevalent in her patients while working in Brigham and Women’s Hospital’s Division of Cardiovascular Medicine.  That, in turn, had ramifications in their self-care.

“Doctors are very good at telling people what they should be doing, eating right, exercising… We [are] trying to get patients to take care of themselves. What we don’t often do is understand what barriers are that keep them from doing the things that they should be doing,” Pande said. “Mental health issues can be a barrier. They can prevent patients from addressing other physical health issues that they know they need to address.”

AbleTo has nearly 700 clinicians, therapists and coaches on its telehealth platform, and operates in all 50 states thanks to partnerships with health plans.

The study is the first time AbleTo has been able to measure the relationship between mental health and heart failure. Pande said it also served as a proof point that behavioral health services are an important part of a patient’s holistic regimen.

“The link between physical health and mental health is increasingly being recognized as important, but that’s a message we have to get out,” she said.

Giving these patients access to behavioral health services can significantly reduce hospital admissions, leading to fewer costly bills. But most importantly, it can help pull patients out of a vicious cycle.

“Having a physical health condition puts you at greater risk of depression or anxiety. It goes the other way too,” she said. “It’s a vicious cycle that if you can break it, you will have a big impact on the patient who will also feel better.”

Photo credit: Pornpak Khunatorn, Getty Images

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