Care Treatment Research Articles

Perioperative Supportive Care Interventions to Enhance Surgical Outcomes for Older Adults With Cancer: A Systematic Review.

Older adults with cancer have unique needs, which likely influence surgical outcomes in the geriatric oncology population. We conducted a systematic review to describe the literature focused on perioperative supportive care interventions for older adults with cancer undergoing surgery. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we performed a comprehensive search using the Ovid MEDLINE, CINAHL, and Embase databases for literature published from January 2010 to October 2023. We included randomized controlled trials (RCTs) focusing on supportive care interventions that enrolled adults older than 60 years with cancer. We included 11 RCTs with 2,177 patients in this review. Patients' age ranged from 60 to 95, and the median number of patients per study was 147 (range, 44-690). Most studies included patients with colorectal cancer (81.8%). Half of the studies (54.5%) evaluated exercise interventions, and the remaining assessed geriatric assessment-guided interventions (27.2%), nutrition optimization (9.1%), and patient empowerment (9.1%). Primary outcomes included postoperative complications, quality of life, feasibility of exercise programs, inspiratory muscle endurance, and hospital length of stay, among others. All studies had postoperative complications as a primary or secondary outcome. We found implementation challenges that influenced several studies, including high dropout rates and intervention fidelity. We found 11 studies focused on perioperative supportive care interventions in older adults with cancer undergoing surgery. Notably, interventions involved exercise, geriatric assessment-guided care, nutrition optimization, and patient empowerment. We also found heterogeneity in intervention modality and outcome assessment, thus demonstrating a need for ongoing work to address the unique needs of the geriatric oncology population.

Effectiveness of Digital Mental Health Interventions in the Workplace: Umbrella Review of Systematic Reviews.

There is potential for digital mental health interventions to provide affordable, efficient, and scalable support to individuals. Digital interventions, including cognitive behavioral therapy, stress management, and mindfulness programs, have shown promise when applied in workplace settings. The aim of this study is to conduct an umbrella review of systematic reviews in order to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. A systematic search was conducted to identify systematic reviews relating to digital interventions for the workplace, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis). The review protocol was registered in the Open Science Framework. The following databases were searched: PubMed, Web of Science, MEDLINE, PsycINFO, and Cochrane Library. Data were extracted using a predefined extraction table. To assess the methodological quality of a study, the AMSTAR-2 tool was used to critically appraise systematic reviews of health care interventions. The literature search resulted in 11,875 records, which was reduced to 14 full-text systematic literature reviews with the use of Covidence to remove duplicates and screen titles and abstracts. The 14 included reviews were published between 2014 and 2023, comprising 9 systematic reviews and 5 systematic reviews and meta-analyses. AMSTAR-2 was used to complete a quality assessment of the reviews, and the results were critically low for 7 literature reviews and low for the other 7 literature reviews. The most common types of digital intervention studied were cognitive behavioral therapy, mindfulness/meditation, and stress management followed by other self-help interventions. Effectiveness of digital interventions was found for many mental health symptoms and conditions in employee populations, such as stress, anxiety, depression, burnout, and psychological well-being. Factors such as type of technology, guidance, recruitment, tailoring, and demographics were found to impact effectiveness. This umbrella review aimed to critically evaluate, synthesize, and summarize evidence of various digital mental health interventions available within a workplace setting. Despite the low quality of the reviews, best practice guidelines can be derived from factors that impact the effectiveness of digital interventions in the workplace. OSF Registries osf.io/rc6ds; https://doi.org/10.17605/OSF.IO/RC6DS.

Synthesizing the Evidence Base to Enhance Coordination between Humanitarian Mine Action and Emergency Care for Casualties of Explosive Ordnance and Explosive Weapons: A Scoping Review.

Humanitarian mine action (HMA) stakeholders have an organized presence with well-resourced medical capability in many conflict and post-conflict settings. Humanitarian mine action has the potential to positively augment local trauma care capacity for civilian casualties of explosive ordnance (EO) and explosive weapons (EWs). Yet at present, few strategies exist for coordinated engagement between HMA and the health sector to support emergency care system strengthening to improve outcomes among EO/EW casualties. A scoping literature review was conducted to identify records that described trauma care interventions pertinent to civilian casualties of EO/EW in resource-constrained settings using structured searches of indexed databases and grey literature. A 2017 World Health Organization (WHO) review on trauma systems components in low- and middle-income countries (LMICs) was updated with additional eligible reports describing trauma care interventions in LMICs or among civilian casualties of EO/EWs after 2001. A total of 14,195 non-duplicative records were retrieved, of which 48 reports met eligibility criteria. Seventy-four reports from the 2017 WHO review and 16 reports identified from reference lists yielded 138 reports describing interventions in 47 countries. Intervention efficacy was assessed using heterogenous measures ranging from trainee satisfaction to patient outcomes; only 39 reported mortality differences. Interventions that could feasibly be supported by HMA stakeholders were synthesized into a bundle of opportunities for HMA engagement designated links in a Civilian Casualty Care Chain (C-CCC). This review identified trauma care interventions with the potential to reduce mortality and disability among civilian EO/EW casualties that could be feasibly supported by HMA stakeholders. In partnership with local and multi-lateral health authorities, HMA can leverage their medical capabilities and expertise to strengthen emergency care capacity to improve trauma outcomes in settings affected by EO/EWs.

The Call to Increase Adoption of Family-Based Interventions in Global Mental Health Programming.

Family-based intervention approaches hold tremendous promise for improving mental health in scalable and relevant ways that address social determinants of health, yet family-focused prevention and care interventions are underused in global mental health. This article provides a brief overview of the evidence and types of programs. It then outlines five future directions for family-focused global mental health interventions: integrating implementation science into family-focused programs, expanding research on family-focused work to other populations and different modalities, encouraging transdisciplinary learning from other fields, understanding what works for whom and where, and disseminating family interventions grounded in locally derived theoretical frameworks.

Process evaluation of a cross-sectoral, coordinated follow-up care of stroke patients: a qualitative study

BackgroundImplementation of interventions to improve follow-up stroke care is complex due to the involvement of various stakeholders and challenges of health care coordination. The aim of this study was to evaluate the process of implementing a cross-sectoral, coordinated follow-up care for stroke patients (the StroCare intervention).MethodsAs part of a multicenter interventional trial, this qualitative study was performed in a pre-post design with semi-structured interviews conducted with patients and health care employees. The multicomponent intervention was implemented in eight participating acute care and rehabilitation clinics. The interviews were analyzed using qualitative content analysis. Contents were coded using eight a priori defined categories (acceptability, adoption, appropriateness, feasibility, fidelity, sustainability, patient-centeredness, satisfaction with treatment, and pandemic-related effects) with the possibility of inductively developed categories.ResultsInterviews with 21 patients and 34 interviews with 23 employees were conducted. In addition to the deductive categories, three inductive categories (psychosocial implications, interconnectedness, and potential for improvement) emerged. Acceptability, adoption, and appropriateness were assessed positively before the intervention. However, poor feasibility had a negative impact on adoption and appropriateness. In contrast, outcomes related to patient care (patient-centeredness and psychosocial implications) were independent from this effect.ConclusionsSimilar to other implementation studies of stroke care interventions, implementation of eHealth Services in the StroCare project met barriers in usability and adaptability of new software. However, high adoption and appropriateness in regard to patient-centeredness, psychosocial implications, and an overall benefit for the patients supported continuation of the remaining intervention components.Trial registration The trial is registered at ClinicalTrials.gov (NCT04159324), registration date 12/11/19.

Evaluating the Performance of Non-invasive Tests for Colorectal Cancer: Statistical Considerations.

Like all interventions in health care, novel non-invasive tests for colorectal cancer should be properly evaluated before they can be recommended. Such evaluations should be performed in well-designed studies, of which the results can serve as the evidence base for recommendations. While the methods for evaluating novel tests have been slower to develop, there is now a solid base for developing suggestions and even strong recommendations for their assessment. These include advice for study design, analysis of results, and clear and informative reporting. These considerations should be guided by the intended use of the new test and its role in the testing pathway. We distinguish between tests proposed as a replacement for an existing test, as a triage test, before an existing test, or as an add-on test, after an existing test. We recommend the definition of explicit, a priori defined, minimally acceptable performance criteria for the intended use of the new test and rigorous statistical hypothesis testing, to prevent "spin" in the interpretation of the findings.

Effect of photobiomodulation as preventive treatment of diabetic foot ulcer: randomised, controlled, double-blind, clinical trial protocol

IntroductionThe prevention of diabetic foot ulcer (DFU) involves the classification of risk, systemic care, regular examinations, foot care, therapeutic education and adjunct treatments. Photobiomodulation (PBM) has been successfully administered for...

A Review of Potentials of Carica Papaya Leaves in Dengue Viral Infection - Insights of Clinical and Preclinical Studies.

One of the most widespread arboviral diseases in the world, dengue virus disease (DVD) is primarily found in tropical and subtropical regions, affecting 129 countries. The main way that the dengue virus (DENV) spreads is through the bite of a female Aedes aegypti mosquito. Symptomatic therapy and supportive care are the primary methods of managing patients with DENV infection as there is currently no approved antiviral medication for this condition. Since the guidelines from the AYUSH Ministry, Government of India, recommend 10 ml of carica papaya leaf extract (CPLE) twice daily for seven days, to treat dengue fever clinically, we plan to review the potential of carica papaya in managing DENV infection.Using terms like dengue, dengue fever, dengue hemorrhagic fever, dengue shock syndrome, and carica papaya, the literature was searched in databases like Medline/PubMed Central/PubMed, Google Scholar, Science Direct, EBSCO, Scopus, Web of Science, EMBASE, Directory of open access journals (DOAJ), and reference lists to find articles relevant to the clinical, in-vivo, in-vitro, and in-silico studies evaluating the efficacy of carica papaya in the management of dengue viral infection. This review included English-language publications that supported the use of carica papaya in the treatment of dengue fever, but it excluded publications that were duplicates.Numerous preclinical and clinical investigations, such as in-vitro, in-vivo, and in-silico studies, have identified carica papaya's anti-dengue potential. The pleiotropic effects of carica papaya, including its anti-thrombocytopenic activity, immunomodulatory effects, and larvicidal property against the Aedes aegypti mosquito species, have also been confirmed by numerous in-vitro and in-vivo studies. These effects can help patients with dengue fever by elevating their platelet count and alleviating other symptoms.To hasten recovery and reduce hospital stays, patients with DENV infection may take carica papaya leaf extract (CPLE) in addition to supportive care and symptomatic treatment. Additional randomized controlled clinical trials would be necessary to confirm the safety and effectiveness of CPLE in patients with DENV infection.

Impact of primary care benefits on healthcare utilisation and estimated out-of-pocket expenses in urban, rural and remote settings in the Philippines

BackgroundThis study aimed to determine the effects of primary care interventions on healthcare utilisation and estimated out-of-pocket (OOP) expenses in selected urban, rural and remote settings in the Philippines.MethodologyContext-specific measures...

Exploring the Physicochemical Compatibility of Minoxidil in Combination with Different Active Pharmaceutical Ingredients in Ready-to-use Vehicles for Alopecia Treatment.

Alopecia is globally known as a distressing medical disorder that affects men and women, and current commercially available minoxidil solutions are formulated with irritant vehicles with frequent complaints of dermatologic adverse effects. This study aimed to investigate further the compatibility of ready-to-use vehicles for the preparation of tailored formulations for alopecia treatment, namely TrichoSol™ (a ready-to-use vehicle for personalized hair solutions) and TrichoFoam™ (a ready-to-use vehicle for personalized foam formulations), in combination with minoxidil and other active pharmaceutical ingredients (APIs), to establish adequate beyond-use dates (BUD) for the given formulations. Products under evaluation were compounded using TrichoSol™ or TrichoFoam™, with direct incorporation of the APIs into these vehicles. Samples were then stored at controlled room temperature for up to 180 days. High-performance liquid chromatography (HPLC) methods were developed and validated, and then utilized to evaluate the compatibility of the APIs in TrichoSol™ and TrichoFoam™. Forced degradation studies were conducted to assess API stability under various stress conditions, and Antimicrobial Effectiveness Testing (AET) was performed at 0 and 180 days after compounding. According to our results, BUDs of up to 90-180 days were obtained for the examined formulations stored at room temperature, considering a degradation of maximum 10% of the nominal concentration of the APIs within them. The formulations exhibited no discernible physical alterations throughout this period and maintained chemical stability within acceptable limits. Microbiological evaluations confirmed the efficacy of the preservative system. Products compounded with TrichoSol™ and TrichoFoam™ showed suitable stability to be used as personalized treatments for alopecia. We can then suggest that the vehicles TrichoSol™ and TrichoFoam™ present effective solutions for compounding personalized hair care treatments.

Exploring the dynamics of SARS-CoV-2 and HIV Co-infection: Mutation risks, therapeutic efficacy, and future variant prevention.

High mutation rates in SARS-CoV-2, particularly among immunocompromised patients living with HIV, continue to complicate the current COVID-19 pandemic. The threshold for severe COVID-19 and a greater risk of mortality have increased in many immunocompromised individuals due to a weakened immune system. Low CD4+ T-cell counts in people living with both HIV and COVID-19 lead to prolonged disease duration and, therefore, an increased likelihood of viral infection with SARS-CoV-2 mutations in such individuals. These mutations could decrease the efficiency of ongoing vaccines and cause new outbreaks. Recently, the rise of new mutations in this patient population has created increasing concern; however, few data are currently available on the direct association of HIV infection with SARS-CoV-2 mutations. This review highlights the implications of SARS-CoV-2 and HIV co-infection, highlighting the need for extra caution and monitoring of the immune-compromised population during a pandemic. Access to HIV care and COVID-19 treatments, careful surveillance, and adapted health strategies are key to reducing risks and protecting these populations. Further research is required to elucidate the dynamics of mutations and develop intervention methods to manage COVID-19 among immunocompromised patients.

Evaluating palliative care's role in symptom management for CKD patients in Egypt: A quasi-experimental approach.

Chronic kidney disease (CKD) is a global health challenge that affects patients' symptom burden and quality of life. Palliative care interventions show promise in addressing the multiple needs of CKD patients, focusing on symptom management, psychosocial support, and advance care planning. This study aimed to evaluate the effectiveness of palliative care interventions in improving symptom management in patients with CKD. The study used a quasi-experimental research design with a sample size of 128 participants diagnosed with CKD. Participants were selected based on strict criteria to ensure consistency of palliative care interventions. Non-probability purposive sampling was used to select participants. Data were collected using validated instruments such as the Edmonton Symptom Assessment System, Kidney Disease Quality of Life-Short Form, Palliative Performance Scale, Dialysis Symptom Index and Functional Assessment of Chronic Illness Therapy-Fatigue. These instruments provided robust measures of symptom severity, quality of life, performance status, symptom burden, and fatigue. The intervention consisted of 4 sessions designed to address symptom management, psychosocial support, and advance care planning strategies. Post-intervention, CKD patients showed significant improvements across multiple measures. Pain decreased from 6.2 to 4.8 (p = 0.002, 23% improvement), and fatigue decreased from 7.5 to 6.1 (p = 0.001, 19% reduction). Depression improved from 5.6 to 4.2 (p = 0.001, 25% reduction) and anxiety decreased from 4.9 to 3.8 (p = 0.004, 22% reduction). Physical functioning increased from 65.3 to 72.1 (p = 0.002, 10% improvement), cognitive function from 72.8 to 78.5 (p = 0.003, 8% increase), and emotional well-being from 60.2 to 65.7 (p = 0.004, 9% improvement). Ambulation improved from 75.2 to 81.5 (p = 0.001, 8% increase), activity from 68.7 to 74.3 (p = 0.004, 8% increase), and self-care from 82.4 to 88.1 (p = 0.003, 7% improvement). Nutritional status improved from 79.6 to 85.2 (p = 0.002, 7% increase) and level of consciousness from 70.3 to 75.8 (p = 0.005, 8% increase). Fatigue scores decreased significantly from 53.2 to 48.6 (p = 0.001, 9% decrease), activities of daily living from 50.1 to 45.8 (p = 0.001, 9% decrease), and well-being from 55.6 to 50.2 (p = 0.001, 10% improvement). The results highlight the potential of palliative care interventions to improve outcomes and well-being for people with CKD. By addressing their complex needs, these interventions offer valuable lessons for nephrology and palliative care practice, emphasizing holistic approaches to patient care. The findings add to the evidence supporting the integration of palliative care into CKD management, highlighting its value in improving patient outcomes and quality of life.

Starting a Prehospital Medication for Opioid Use Disorder Program.

Over 2.7 million people have an opioid use disorder (OUD). Opioid-related deaths have steadily increased over the last decade. Although emergency department (ED)-based medication for OUD (MOUD) has been successful in initiating treatment for patients, there still is a need for improved access. This study describes the development of a prehospital MOUD program. An interdisciplinary team expanded a MOUD program into the prehospital setting through the local city fire department Quick Response Team (QRT) to identify patients appropriate for MOUD treatment. The QRT consisted of a paramedic, social worker, and police officer. This team visited eligible patients (i.e., history of an opioid overdose and received prehospital care the previous week). The implementation team developed a prehospital MOUD protocol and a two-hour training course for QRT personnel. Implementation also required a signed contract between local hospitals and the fire department. A drug license was necessary for the QRT vehicle to carry buprenorphine/naloxone, and a process to restock the vehicle was created. Pamphlets were created to provide to patients. A clinical algorithm was created for substance use disorder (SUD) care coordinators to provide a transition of care for patients. Metrics to evaluate the program included the number of patients seen, the number enrolled in an MOUD program, and the number of naloxone kits dispensed. Data were entered into iPads designated for the QRT and uploaded into the Research Electronic Data Capture (REDCap) program. Over the six-month pilot, the QRT made 348 visits. Of these, the QRT successfully contacted 83 individuals, and no individuals elected to be evaluated for new MOUD treatment. Nine fatal opioid overdoses occurred during the study period. A total of 55 naloxone kits were distributed, and all patients received MOUD information pamphlets. A prehospital MOUD program can be established to expand access to early treatment and continuity of care for patients with OUD. The program was well-received by the local city fire department and QRT. There is a plan to expand the prehospital MOUD program to other local fire departments with QRTs.

Emotional and psychosocial functioning in youngsters with a congenital heart disease (CHD) in comparison to healthy controls.

Due to their medical vulnerability, youngsters with congenital heart disease (CHD) may experience more overwhelming emotions than healthy peers. This multi-informant-based study aims to examine differences between these youngsters and their peers in psychosocial functioning, attachment and emotion regulation. 217 youngsters (8-18years) with CHD (53.9% boys, 46.1% girls) were compared to 232 healthy controls (52.6% boys, 47.4% girls) matched for gender, age and education. Participants and parents completed online self-report questionnaires assessing psychosocial functioning (SDQ), attachment (ECR-RC), and maladaptive Emotion Regulation Strategies (ERS; FEEL-KJ). Based on child's self-reports MANOVA's showed no significant differences between the groups in psychosocial functioning. However, based on parent reports, differences were found between the groups in psychosocial functioning for the total scales and overarching subscales. No differences were found between the groups for insecure attachment to either parent. However, youngsters with CHD and their fathers reported more use of self-devaluation compared to controls (p=.03). Other maladaptive ERS (giving up, withdrawal, rumination, aggressive actions) showed no differences. Care interventions for children with CHD should address medical, emotional, and social needs, with a focus on multi-informant evaluations to support emotional well-being. Nurses are important partners in detecting psychosocial difficulties and providing family support. Patient- and family-centered care involves patients, parents and caregivers in the care plan, recognizing their key role, especially as youngsters often perceive their psychosocial health differently than their parents. Although differences were noted compared to the control group, the study's cross-sectional design limits conclusions on evolution with time.

Neighbourhood socioeconomic conditions and emergency admissions for ambulatory care sensitive conditions in children: a longitudinal ecological analysis in England, 2012–2017

BackgroundAmbulatory care sensitive conditions (ACSCs) are those for which hospital admission could be prevented by interventions in primary care. Children living in socioeconomic disadvantage have higher rates of emergency admissions...

Randomized clinical trial of peer integrated collaborative care intervention after physical injury

ObjectivesThe goal of the current study was to assess the effectiveness of a peer integrated collaborative care intervention for postinjury outcomes.MethodsInjury survivors ≥18 years of age were screened for post-traumatic...

Impact of invasive infections on clinical outcomes in acute pancreatitis: early predictive factors and implications for prophylactic anti-infective therapy

BackgroundThe use of antibiotic therapy in acute pancreatitis remains controversial and is currently recommended only for confirmed infections of peripancreatic necrosis. However, reliable early predictors of septic complications and unfavorable outcomes are substantially lacking.MethodsPatients with acute pancreatitis were retrospectively reviewed and divided into two groups: one with a septic course defined by pathogen detection [GERM(+)] and one without [GERM(-)]. After propensity score matching, both groups were compared regarding clinical outcomes. Early predictors of pathogen detection were evaluated by multivariate analysis.Results424 patients with acute pancreatitis were included. After propensity score matching 123 GERM(-) patients were compared to 74 GERM(+) patients. GERM(+) patients demonstrated significantly worse clinical outcomes with higher rate of intensive care treatment (59.5% vs. 35.0%; p = 0.0011) and consecutive longer stay in intensive care unit (11.5 ± 25.2d vs. 3.0 ± 7.9d; p = 0.0007), longer in-hospital stay (26.8 ± 22.0d vs. 14.7 ± 15.0d; p = 0.0003) as well as worse results in the composite outcome length of in-hospital stay > 15d or death (67.6% vs. 31.7%; p < 0.0001). Prescence of ascites and elevated white blood cell count at the onset of acute pancreatitis were identified as significant predictive factors in the early disease associated with invasive infection and pathogen detection. The most frequently detected pathogens were commensals of the gastrointestinal tract, observed in 70.7% of the examined body fluids and 50.7% of the examined blood cultures.ConclusionsDetection of pathogens is associated with unfavorable clinical outcomes in acute pancreatitis. The presence of ascites and elevated white blood cell count at onset of acute pancreatitis are significant predictive factors indicating the risk of invasive infection with relevant bacterial load. Thus, an aggressive, early anti-infective strategy against pathogens of intestinal origin should be considered in these cases and may improve patient outcomes.

Advances in 3D correction of adolescent scoliosis: The superiority of scoliocorrector fatma-UI in rotational realignment.

This letter compares the clinical efficacy and economic feasibility of the scoliocorrector fatma-UI (SCFUI) with direct vertebral rotation (DVR) in treating adolescent idiopathic scoliosis (AIS). SCFUI has shown promising results in three-dimensional spinal correction, providing superior rotational alignment compared to DVR and achieving significant improvements in coronal and sagittal planes. Additionally, SCFUI's advanced design reduces risks associated with AIS surgeries and enhances overall patient outcomes. Economic analysis reveals SCFUI as a cost-effective option, potentially lowering long-term healthcare costs by minimizing complications and revisions. Our findings suggest that SCFUI is a viable, innovative approach in AIS treatment, meeting clinical and economic demands in orthopedic care.

The effect of enhanced recovery protocols on postoperative rehabilitation in orthopedic surgery patients.

Orthopedics is a critical hospital department that has experienced shifts in the spectrum of orthopedic conditions due to societal advancements in recent years. While surgical interventions are effective in restoring fracture function, perioperative care remains a key factor in optimizing patient recovery. This study aims to assess the impact of orthopedic rehabilitation care based on the enhanced recovery after surgery (ERAS) protocol on postoperative rehabilitation. A total of 836 patients who underwent orthopedic surgery from June 2023 to June 2024 were included in the study. They were divided into a control group, which received standard care, and an observation group, which received care interventions based on ERAS principles. Recovery outcomes were assessed by measuring hospital stay duration, fracture healing time, joint function recovery time, and the incidence of complications in both groups. The observation group showed significantly shorter hospital stays, faster fracture healing times, and quicker joint function recovery compared with the control group. Furthermore, the incidence of complications was notably lower in the observation group. Postoperative joint function recovery scores and patient satisfaction were also higher in the observation group, with statistically significant differences between the 2 groups (P < .05). ERAS-based care enhances orthopedic recovery by reducing hospital stays, accelerating functional recovery, lowering complications, and improving patient satisfaction, proving its effectiveness in perioperative cares, and should be widely implemented in orthopedic rehabilitation.

Adapting and Implementing a Blended Collaborative Care Intervention for Older Adults with Multimorbidity: Quantitative and Qualitative Results from the ESCAPE Pilot Study.

Multimorbidity poses significant challenges for patients and healthcare systems, often exacerbated by fragmented care and insufficient collaboration across providers. Blended Collaborative Care (BCC) is a promising strategy to address care complexity by partnering care managers (CMs) with primary care providers (PCPs) and specialists. This study aimed to adapt and pilot a BCC intervention for patients aged 65+ with heart failure and physical-mental multimorbidity. Our objectives were to assess the feasibility of the study procedures, patient recruitment, participant satisfaction and acceptability, and to identify necessary adjustments for improving intervention delivery. We evaluated goal attainment and intervention fidelity through standardised electronic documentation by CMs, and patient acceptance and satisfaction through semi-structured interviews. A monocentric, one-arm pilot study involved nine patients with a mean of 6.7 contacts with their CM over three months. Patients' health goals primarily focused on lifestyle changes and psychosocial support. The intervention was generally well-accepted, with no reported negative consequences. Difficulties in establishing working alliances with PCPs were a barrier to effective implementation. The analysis indicated the need for minor procedural adjustments. Next steps include launching the ESCAPE trial, a large randomised-controlled trial across different European healthcare systems and developing strategies to facilitate PCP involvement.