Heart Failure Clinical Trial
Official title:
Design of a Mobile Technology-Based System for Patient Engagement and Physician-Directed Remote Management of Heart Failure
This pilot study is to assess the feasibility, preliminary utility and acceptance of a digital technology-based system for heart failure management.
Status | Not yet recruiting |
Enrollment | 30 |
Est. completion date | April 15, 2024 |
Est. primary completion date | December 31, 2023 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Age = 18 - Diagnosis of heart failure - Most recent left ventricular ejection fraction = 40% in the prior year based on echocardiogram, MRI, CT, or nuclear perfusion - Primary cardiologist enrolled in the study - Currently admitted with upcoming discharge or discharged from hospital within the prior 2 weeks - At least two eligible heart failure therapies (guideline-recommended BB, RASI, MRA, or SGLT2i) not yet initiated or on = 50% of target dose Exclusion Criteria: - Receives dialysis - Inotropic therapy during hospitalization - History of heart transplant or actively listed on heart transplant waiting list - History of left ventricular assist device implantation - Cardiac amyloidosis - Pregnant or currently trying to be pregnant - Life expectancy estimated less than 6 months related to non-cardiac comorbidities as per investigator's judgement - Actively enrolled in hospice or comfort care - Currently participating in an investigational device or drug study or having participated in such a study within 30 days prior to screening - Subject or their caregiver without a smartphone - Subject or their caregiver not proficient with written and spoken English - Subject unavailable to complete all study procedures (e.g., interviews) to the best of the subject and investigator's knowledge - Any other disorder or condition that, in the opinion of the investigator would pose a risk to subject safety or interfere with the study evaluation, procedures or completion - Subject has diminished decision-making capacity - Planned discharge to skilled nursing facility |
Country | Name | City | State |
---|---|---|---|
United States | Stanford Hospital & Clinics | Stanford | California |
Lead Sponsor | Collaborator |
---|---|
Stanford University |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Patient Acceptability of the intervention | The proportion of patients who assess the DOT-HF intervention as an acceptable method of post-discharge heart failure management. This will be assessed during a semi-structured interview between individual participants and a trained interviewer. | At Study completion (12-week follow-up visit) | |
Primary | Patients' Engagement score | A weighted proportion of requested actions completed by the patient. These actions include daily blood pressure measurements, daily weight assessment, daily health status assessment, biweekly KCCQ-12 assessment, and review of educational videos and health summary data. The minimum score is 0% and maximum score is 100%. | At Study completion (12-week follow-up visit) | |
Primary | Clinicians' Response to Notification | The proportion of DOT-HF clinician notifications that lead to a clinician response over the 12-week follow-up period. Each of the clinician DOT-HF notifications are detailed below. These include notification of eligible therapy adjustment, worsening patient-reported health status, and weight gain. Eligible clinician actions include medication changes or new telephone, video, or in-person clinic encounters in response to the notification. | At Study completion (12-week follow-up visit) | |
Secondary | Proportion of days with weight assessed | The proportion of days weight is recorded by the participant using the ENGAGE-HF app. The minimum is 0% and maximum is 100%. | At Study Completion (12-week follow-up visit) | |
Secondary | Proportion of days with daily health status completed | The proportion of days daily health status is recorded by the participant using the ENGAGE-HF app. The minimum is 0% and maximum is 100%. | At Study Completion (12-week follow-up visit) | |
Secondary | Proportion of Kansas City Cardiomyopathy Questionnaire-12 assessments completed | The proportion of biweekly periods that the Kansas City Cardiomyopathy Questionnaire-12 health status is recorded by the participant using the ENGAGE-HF app. The minimum is 0% and maximum is 100%. | At Study Completion (12-week follow-up visit) | |
Secondary | Proportion of days with blood pressure (systolic) assessed | The proportion of days blood pressure (systolic) is recorded by the participant using the ENGAGE-HF app. The minimum is 0% and maximum is 100%. | At Study Completion (12-week follow-up visit) | |
Secondary | Proportion of days with medication adherence assessed | The proportion of days medication adherence is recorded by the participant using the ENGAGE-HF app. The minimum is 0% and maximum is 100%. | At Study Completion (12-week follow-up visit) | |
Secondary | Sustainability of DOT-HF technology for Patients | Sustainability will also be assessed via semi-structured interview questions to assess patient's and clinician's interest in continuing to use the DOT-HF intervention. | At 6 week, At Study Completion (12-week follow-up visit) | |
Secondary | Feasibility of DOT-HF technology for Patients | Feasibility will be assessed via semi-structured interview questions to assess barriers to use the DOT-HF intervention. | At Study Completion (12 week follow up visit) | |
Secondary | Utility of DOT-HF technology for Clinicians | Clinician perception of the utility of DOT-HF will be assessed based on clinician actions in response to DOT-HF notifications. We will assess each of the types of notifications aggregated in co-primary endpoint #3: Notification of eligible therapy adjustment Worsening patient-reported health status Weight gain For each endpoint, we will separately evaluate the proportion of notifications that were followed by a medication adjustment and the proportion that were followed by a previously unplanned encounter between the clinician/clinic nurse and the patient. |
At study completion (12 week follow up visit) | |
Secondary | Acceptability of DOT-HF technology for Clinicians | Clinician perception of the acceptability of DOT-HF will be assessed by clinician responses to a survey administered at the end of the study and semi-structured interview. | At study completion (12 week follow up visit) | |
Secondary | Generalizability of the DOT-HF Intervention | The generalizability of our study will be evaluated by comparing sociodemographic data between participants and eligible individuals who decline participation. Sociodemographics include age, gender, and race. | At study completion (12 week follow up visit) | |
Secondary | Guideline-Directed Medical Therapy Score | A score based on the heart failure medications prescribed. The minimum score is 0% and maximum score is 100%. | Baseline, At study completion (12 week follow-up visit) |
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT05654272 -
Development of CIRC Technologies
|
||
Recruiting |
NCT05196659 -
Collaborative Quality Improvement (C-QIP) Study
|
N/A | |
Recruiting |
NCT05650307 -
CV Imaging of Metabolic Interventions
|
||
Active, not recruiting |
NCT05896904 -
Clinical Comparison of Patients With Transthyretin Cardiac Amyloidosis and Patients With Heart Failure With Reduced Ejection Fraction
|
N/A | |
Completed |
NCT05077293 -
Building Electronic Tools To Enhance and Reinforce Cardiovascular Recommendations - Heart Failure
|
||
Recruiting |
NCT05631275 -
The Role of Bioimpedance Analysis in Patients With Chronic Heart Failure and Systolic Ventricular Dysfunction
|
||
Enrolling by invitation |
NCT05564572 -
Randomized Implementation of Routine Patient-Reported Health Status Assessment Among Heart Failure Patients in Stanford Cardiology
|
N/A | |
Enrolling by invitation |
NCT05009706 -
Self-care in Older Frail Persons With Heart Failure Intervention
|
N/A | |
Recruiting |
NCT04177199 -
What is the Workload Burden Associated With Using the Triage HF+ Care Pathway?
|
||
Terminated |
NCT03615469 -
Building Strength Through Rehabilitation for Heart Failure Patients (BISTRO-STUDY)
|
N/A | |
Recruiting |
NCT06340048 -
Epicardial Injection of hiPSC-CMs to Treat Severe Chronic Ischemic Heart Failure
|
Phase 1/Phase 2 | |
Recruiting |
NCT05679713 -
Next-generation, Integrative, and Personalized Risk Assessment to Prevent Recurrent Heart Failure Events: the ORACLE Study
|
||
Completed |
NCT04254328 -
The Effectiveness of Nintendo Wii Fit and Inspiratory Muscle Training in Older Patients With Heart Failure
|
N/A | |
Completed |
NCT03549169 -
Decision Making for the Management the Symptoms in Adults of Heart Failure
|
N/A | |
Recruiting |
NCT05572814 -
Transform: Teaching, Technology, and Teams
|
N/A | |
Enrolling by invitation |
NCT05538611 -
Effect Evaluation of Chain Quality Control Management on Patients With Heart Failure
|
||
Recruiting |
NCT04262830 -
Cancer Therapy Effects on the Heart
|
||
Completed |
NCT06026683 -
Conduction System Stimulation to Avoid Left Ventricle Dysfunction
|
N/A | |
Withdrawn |
NCT03091998 -
Subcu Administration of CD-NP in Heart Failure Patients With Left Ventricular Assist Device Support
|
Phase 1 | |
Recruiting |
NCT05564689 -
Absolute Coronary Flow in Patients With Heart Failure With Reduced Ejection Fraction and Left Bundle Branch Block With Cardiac Resynchronization Therapy
|