Assessment Of Educational Strategies In Heart Failure Patients Presenting To The Emergency Department For Care

Heart Failure Clinical Trial

Official title:

Assessment Of Patient Knowledge And Effects Of Educational Strategies In Un- And Under-Insured Heart Failure Patients Presenting To The Emergency Department For Care

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03143881
• Other study ID #: 32676
• Status: Completed
• Phase: N/A
• First received: May 4, 2017
• Last updated: May 5, 2017
• Start date: June 1, 2015
• Est. completion date: January 1, 2017

Study information

• Verified date: May 2017
• Source: Baylor College of Medicine
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study evaluates the impact of a new education-based intervention on outcomes in un- and under-insured Heart Failure (HF) patients presenting to the Emergency Department (ED) for care. Intervention patients will receive personalized education regarding their condition, pre- and post-testing of their HF knowledge base, and ED standard of care during the enrollment (index) visit. Patients will then be contacted via telephone 30 days post-index visit for re-testing and reinforcement of previously learned material. Patients in the control group will receive ED standard of care.

Description:

In 2015, 12.8% of adults ages 19-64 in the United States lacked any form of health insurance. An even greater number fell under the umbrella of under-insured. Studies indicate that the un- and under-insured receive less preventive care, are diagnosed at more advanced disease stages, and have higher mortality rates than their insured counterparts, due to the lack of accessible primary care services. These issues are most readily evident in patients with chronic conditions. When a preventable, chronic condition worsens, these patients have no choice but to visit the ED to address their most immediate health concerns, leaving the underlying chronic problem untreated. HF is a particularly burdensome chronic problem for patients of all socioeconomic statuses and one of the leading causes of ED and hospital readmissions.

Numerous educational efforts have been tested in an attempt to reduce HF readmissions but have met with mixed results. Consequently, HF patients are generally seen as refractory to educational and management strategies. The investigators propose here a new, targeted educational intervention designed to improve patient outcomes and readmission rates in un- and underinsured HF patients.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 94
• Est. completion date: January 1, 2017
• Est. primary completion date: March 31, 2016
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Patients with a pre-existing documented diagnosis of HF presenting to the ED

Exclusion Criteria:

• 1) Patients in unstable condition requiring immediate medical attention, 2) hemodynamically unstable, 3) age < 18 years, and/or 4) incarcerated.

Related Conditions & MeSH terms

• Emergencies
• Heart Failure

Intervention

Behavioral:
• Education
Standardized information on the etiology of HF, mechanisms and side effects of medications prescribed, strategies for minimizing exacerbations, and warning signs of worsening clinical status will be discussed with the patient.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Baylor College of Medicine

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in ED revisits	Change in the number of HF-specific ED revisits over the 30- and 90-day periods, pre- and post-index visit.	30 and 90 days
Primary	Change in hospital readmissions	Change in the number of HF-specific hospital readmissions over the 30- and 90-day periods, pre- and post-index visit.	30 and 90 days
Secondary	Days alive and out of hospital (DAOH)	Days alive and out of hospital (DAOH) over a 365 day period post-index visit	365 days (1 year)