Please select the eligibility criteria that correspond to the clinical trial below.
Title: Collaborative Care to Alleviate Symptoms and Adjust to Illness in Chronic Heart Failure (CASA) Trial
Brief Summary: Chronic heart failure is an important public health problem as it is a leading cause of disability, hospitalization, death, and costs. People who live with advanced chronic heart failure suffer from numerous symptoms that affect their daily lives. The investigators are conducting a randomized clinical trial to evaluate a symptom management and psychosocial care intervention to improve health status (symptom burden, functioning, and quality of life). The results will be directly relevant to patients and families who suffer with this illness, as well as to providers, payers, and other researchers.


Options:
A: Inclusion Criteria:

* Age 18 years of age or older
* Able to read and understand English
* Consistent access to a telephone
* Patients have a primary care or other provider who is willing to facilitate intervention medical recommendations
* A diagnosis of heart failure with at least one of the following:

\[hospitalization primarily for heart failure in the year prior (including current); taking at least 20 mg oral furosemide (or equivalent) daily in a single or divided dose; Brain natriuretic peptide(BNP) ≥ 100 or N-terminal prohormone of brain natriuretic peptide(NT-proBNP) ≥ 500; EF≤40%\]

* Report a low health status (KCCQ-SF≤70)
* Bothered by at least one target symptom:

\[Pain; Depression; Fatigue; Breathlessness\]

Exclusion Criteria:

* Previous diagnosis of dementia
* Active substance abuse or dependence, defined by either a diagnosis of abuse or dependence or an AUDIT-C ≥ 8, or self-reported substance abuse in the past 3 months
* Comorbid metastatic cancer
* Nursing home resident
* Heart Transplant recipient
* LVAD recipient
B: Inclusion Criteria:

* Patients younger than 75 years with a recent acute MI (\< 3 months)
* Depression and/or anxiety score of \> 7 on one or both of the HADS subscales (concerns only the intervention, not the reference group)

Exclusion Criteria:

* Patients that are scheduled for a coronary artery bypass surgery (CABG)
* Unable or unwilling to use computer or Internet
* Difficulties in reading or understanding Swedish
* A life expectancy of less than a year
* Anticipated poor compliance (multi-disease, substance abuse etc.)
* Highly depressed or suicidal (MADRS-score \> 29 or MADRS item 9 \> 3)
C: Inclusion Criteria:

1. Hospitalization with a verified diagnosis of unstable angina (UA) or acute myocardial infarction (AMI). UA is defined as new-onset angina within 2 months, exacerbation of previous angina with pain at rest or with minimal exercise, prolonged chest pain (lasting \> 20 minutes), or angina within 2 weeks following discharge for myocardial infarction in patients with documented coronary artery disease (defined as ischemic ECG ST-T segment changes, previously documented MI, positive nuclear treadmill test result, or coronary angiographic evidence of blockage of 50% stenosis in \>1 major coronary artery). AMI is defined as at least 2 of the following: ischemic chest pain lasting \>20 minutes, acute rise in serum troponin-I \>1.0 ng/L, and new pathologic ST segments in \>2 contiguous ECG leads.
2. Score on the Beck Depression Inventory (BDI) \> 10 within 7 days of index ACS event and 3-months later.

Exclusion Criteria:

1. active suicidal or homicidal ideation, as these patients require immediate referral for assessment and treatment (see below for procedures for these patients);
2. current alcohol or other substance abuse disorders (as depressive symptoms may be a result of these disorders),
3. any current psychotic disorder,
4. history of psychotic disorder, bipolar disorder, or serious personality disorders,
5. diagnosis of a terminal non-cardiac illness,
6. ACS diagnosis secondary to diagnosis of a severe medical disease,
7. inability to communicate in English,
8. levels of cognitive impairment indicative of dementia,
9. unavailability for the period of the study,
10. overt hypothyroid, and
11. currently taking triptans.
D: Inclusion Criteria:

* Meets the DSM-IV criteria for a current major depressive episode
* Score of 15 or higher on the Beck Depression Inventory II
* History of acute myocardial infarction, unstable angina, or documented coronary disease

Exclusion Criteria:

* Physician or patient refusal
* Lives far away from study site
* Current alcohol or drug abuse
* Psychosis, dementia, or bipolar disorder
* Already taking Omega-3
* Medically ill or disabled such that patient is unable to participate
* Comorbid illness likely to be fatal within 1 year of study entry
* Seizure disorder or takes anticonvulsants
* Pregnant or breast feeding
* Liver or kidney disease
* Severe hypertriglyceridemia (greater than 400 mg/dL)
* Bleeding or clotting disorder
* Type 2 diabetes with a hemoglobin A1c (HbA1c) level greater than 10
* Taking lithium or monoamine oxidase inhibitor (MAO-I)

Answer: A