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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT05285969
Other study ID # HCB/2019/0727
Secondary ID
Status Recruiting
Phase N/A
First received
Last updated
Start date April 1, 2022
Est. completion date December 1, 2025

Study information

Verified date March 2023
Source Consorci d'Atenció Primària de Salut de l'Eixample
Contact Luis González de Paz, PhD
Phone 0034 932275683
Email lgonzale@clinic.cat
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Introduction: Secondary prevention after acute myocardial infarction may include cardiac rehabilitation and lifestyle changes. Cardiac rehabilitation has mainly taken place in hospitals without coordination with primary healthcare. Motivational interviews have been shown to be effective as a means for change in patients after acute myocardial infarction. The objective of this study is to evaluate the effectiveness of a cardiac rehabilitation program with motivational interviews in patients discharged from hospital after acute myocardial infarction. Methods: Randomized clinical non-pharmacological trial. A minimum sample of 284 participants requiring cardiac rehabilitation after acute myocardial infarction in six primary healthcare centers. Participants will be randomized to cardiac rehabilitation with motivational interviews or normal standard of care. All secondary results will be evaluated at 1,3 and 6 months.


Recruitment information / eligibility

Status Recruiting
Enrollment 284
Est. completion date December 1, 2025
Est. primary completion date October 1, 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Age >18 years. - Hospital admission for acute coronary syndrome (diagnostic codes ICD-10: I20-I22). - Post unscheduled cardiac revascularization surgery (procedure code ICD-10: 021x). - Discharge to home with the area of the 7 PHCs. - Indication of RC indication. - Voluntary participation. Exclusion Criteria: - Acute aortic disease, - Severe pulmonary hypertension. - Uncontrolled arrhythmias. - Decompensated Heart Failure or significant valvular or congenital heart disease. - Intervention in heart valves and/or interventricular septum. - Diseases that prevent exercise. - Osteoarticular disease that severely limits exercise. - Severe mental disorder. - Any severe psychiatric disorders. - Cognitive disability. - Verbal communication problems. - Participation in hospital Cardiac Rehabilitation.

Study Design


Intervention

Behavioral:
Motivational interview
The new CR program with MI will be structured in 4 sessions and an optional fifth during the six months after discharge. The methodology of the MI sessions will follow the four phases logical sequence of MI proposed by Rollnick and Millner. 1) engage in a collaborative relationship, 2) focus on a particular change, 3) evoke intrinsic motivations for change, and 4) plan an immediate step for change
Active Comparator: Standard care group
All patients in the control group will receive a kit with informative material with the actions and procedures to follow (diet, physical activity, smoking cessation, and other recommendations about secondary prevention).

Locations

Country Name City State
Spain CAP Compte Borrell Barcelona
Spain Centre Atenció Primària Casanova Barcelona
Spain Centre Atenció Primària de Les Corts Barcelona
Spain Centre Atenció Primària Montengre Barcelona

Sponsors (6)

Lead Sponsor Collaborator
Consorci d'Atenció Primària de Salut de l'Eixample Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina, Hospital Clinic of Barcelona, Institut Català de la Salut, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Instituto de Salud Carlos III

Country where clinical trial is conducted

Spain, 

References & Publications (32)

Abreu A, Pesah E, Supervia M, Turk-Adawi K, Bjarnason-Wehrens B, Lopez-Jimenez F, Ambrosetti M, Andersen K, Giga V, Vulic D, Vataman E, Gaita D, Cliff J, Kouidi E, Yagci I, Simon A, Hautala A, Tamuleviciute-Prasciene E, Kemps H, Eysymontt Z, Farsky S, Hayward J, Prescott E, Dawkes S, Pavy B, Kiessling A, Sovova E, Grace SL. Cardiac rehabilitation availability and delivery in Europe: How does it differ by region and compare with other high-income countries?: Endorsed by the European Association of Preventive Cardiology. Eur J Prev Cardiol. 2019 Jul;26(11):1131-1146. doi: 10.1177/2047487319827453. Epub 2019 Feb 20. — View Citation

Arena R, Williams M, Forman DE, Cahalin LP, Coke L, Myers J, Hamm L, Kris-Etherton P, Humphrey R, Bittner V, Lavie CJ; American Heart Association Exercise, Cardiac Rehabilitation and Prevention Committee of the Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Council on Nutrition, Physical Activity and Metabolism. Increasing referral and participation rates to outpatient cardiac rehabilitation: the valuable role of healthcare professionals in the inpatient and home health settings: a science advisory from the American Heart Association. Circulation. 2012 Mar 13;125(10):1321-9. doi: 10.1161/CIR.0b013e318246b1e5. Epub 2012 Jan 30. No abstract available. — View Citation

Bjarnason-Wehrens B, McGee H, Zwisler AD, Piepoli MF, Benzer W, Schmid JP, Dendale P, Pogosova NG, Zdrenghea D, Niebauer J, Mendes M; Cardiac Rehabilitation Section European Association of Cardiovascular Prevention and Rehabilitation. Cardiac rehabilitation in Europe: results from the European Cardiac Rehabilitation Inventory Survey. Eur J Cardiovasc Prev Rehabil. 2010 Aug;17(4):410-8. doi: 10.1097/HJR.0b013e328334f42d. — View Citation

Bohplian S, Bronas UG. Motivational Strategies and Concepts to Increase Participation and Adherence in Cardiac Rehabilitation: AN INTEGRATIVE REVIEW. J Cardiopulm Rehabil Prev. 2022 Mar 1;42(2):75-83. doi: 10.1097/HCR.0000000000000639. — View Citation

Brodie DA, Inoue A, Shaw DG. Motivational interviewing to change quality of life for people with chronic heart failure: a randomised controlled trial. Int J Nurs Stud. 2008 Apr;45(4):489-500. doi: 10.1016/j.ijnurstu.2006.11.009. Epub 2007 Jan 26. — View Citation

Buckingham SA, Taylor RS, Jolly K, Zawada A, Dean SG, Cowie A, Norton RJ, Dalal HM. Home-based versus centre-based cardiac rehabilitation: abridged Cochrane systematic review and meta-analysis. Open Heart. 2016 Sep 14;3(2):e000463. doi: 10.1136/openhrt-2016-000463. eCollection 2016. — View Citation

Chew HSJ, Cheng HY, Chair SY. The suitability of motivational interviewing versus cognitive behavioural interventions on improving self-care in patients with heart failure: A literature review and discussion paper. Appl Nurs Res. 2019 Feb;45:17-22. doi: 10.1016/j.apnr.2018.11.006. Epub 2018 Nov 7. — View Citation

Dalal HM, Doherty P, Taylor RS. Cardiac rehabilitation. BMJ. 2015 Sep 29;351:h5000. doi: 10.1136/bmj.h5000. No abstract available. — View Citation

Flores PVP, Rocha PA, Figueiredo LDS, Guimaraes TML, Velasco NS, Cavalcanti ACD. Effect of motivational interviewing on self-care of people with heart failure: a randomized clinical trial. Rev Esc Enferm USP. 2020 Nov 6;54:e03634. doi: 10.1590/S1980-220X2019013703634. eCollection 2020. English, Portuguese. — View Citation

Gene-Badia J, Ascaso C, Escaramis-Babiano G, Sampietro-Colom L, Catalan-Ramos A, Sans-Corrales M, Pujol-Ribera E. Personalised care, access, quality and team coordination are the main dimensions of family medicine output. Fam Pract. 2007 Feb;24(1):41-7. doi: 10.1093/fampra/cml056. Epub 2006 Nov 1. — View Citation

Hardcastle SJ, Taylor AH, Bailey MP, Harley RA, Hagger MS. Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow-up. Int J Behav Nutr Phys Act. 2013 Mar 28;10:40. doi: 10.1186/1479-5868-10-40. — View Citation

Haykowsky M, Scott J, Esch B, Schopflocher D, Myers J, Paterson I, Warburton D, Jones L, Clark AM. A meta-analysis of the effects of exercise training on left ventricular remodeling following myocardial infarction: start early and go longer for greatest exercise benefits on remodeling. Trials. 2011 Apr 4;12:92. doi: 10.1186/1745-6215-12-92. — View Citation

Jokar F, Yousefi H, Yousefy A, Sadeghi M. Begin Again and Continue With Life: A Qualitative Study on the Experiences of Cardiac Rehabilitation Patients. J Nurs Res. 2017 Oct;25(5):344-352. doi: 10.1097/JNR.0000000000000220. — View Citation

Kotseva K, Wood D, De Bacquer D, De Backer G, Ryden L, Jennings C, Gyberg V, Amouyel P, Bruthans J, Castro Conde A, Cifkova R, Deckers JW, De Sutter J, Dilic M, Dolzhenko M, Erglis A, Fras Z, Gaita D, Gotcheva N, Goudevenos J, Heuschmann P, Laucevicius A, Lehto S, Lovic D, Milicic D, Moore D, Nicolaides E, Oganov R, Pajak A, Pogosova N, Reiner Z, Stagmo M, Stork S, Tokgozoglu L, Vulic D; EUROASPIRE Investigators. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol. 2016 Apr;23(6):636-48. doi: 10.1177/2047487315569401. Epub 2015 Feb 16. — View Citation

Martín R. Efectividad de la rehabilitación cardíaca en un grupo de pacientes de alto riesgo. Rev Enferm Cardiol. 2018;25(75):34-39.

Masterson Creber R, Patey M, Lee CS, Kuan A, Jurgens C, Riegel B. Motivational interviewing to improve self-care for patients with chronic heart failure: MITI-HF randomized controlled trial. Patient Educ Couns. 2016 Feb;99(2):256-64. doi: 10.1016/j.pec.2015.08.031. Epub 2015 Aug 29. — View Citation

Palomo L, Gene-Badia J, Rodriguez-Sendin JJ. [The reform of primary care, between the last refuge of adventure and innovation. SESPAS report 2012]. Gac Sanit. 2012 Mar;26 Suppl 1:14-9. doi: 10.1016/j.gaceta.2011.06.010. Epub 2011 Oct 11. Spanish. — View Citation

Paradis V, Cossette S, Frasure-Smith N, Heppell S, Guertin MC. The efficacy of a motivational nursing intervention based on the stages of change on self-care in heart failure patients. J Cardiovasc Nurs. 2010 Mar-Apr;25(2):130-41. doi: 10.1097/JCN.0b013e3181c52497. — View Citation

Piepoli MF, Corra U, Adamopoulos S, Benzer W, Bjarnason-Wehrens B, Cupples M, Dendale P, Doherty P, Gaita D, Hofer S, McGee H, Mendes M, Niebauer J, Pogosova N, Garcia-Porrero E, Rauch B, Schmid JP, Giannuzzi P. Secondary prevention in the clinical management of patients with cardiovascular diseases. Core components, standards and outcome measures for referral and delivery: a policy statement from the cardiac rehabilitation section of the European Association for Cardiovascular Prevention & Rehabilitation. Endorsed by the Committee for Practice Guidelines of the European Society of Cardiology. Eur J Prev Cardiol. 2014 Jun;21(6):664-81. doi: 10.1177/2047487312449597. Epub 2012 Jun 20. — View Citation

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, Gonzalez-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P; ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016 Jul 14;37(27):2129-2200. doi: 10.1093/eurheartj/ehw128. Epub 2016 May 20. No abstract available. Erratum In: Eur Heart J. 2016 Dec 30;: — View Citation

Poudel N, Kavookjian J, Scalese MJ. Motivational Interviewing as a Strategy to Impact Outcomes in Heart Failure Patients: A Systematic Review. Patient. 2020 Feb;13(1):43-55. doi: 10.1007/s40271-019-00387-6. — View Citation

Pujol Ribera E, Gene Badia J, Sans Corrales M, Sampietro-Colom L, Pasarin Rua MI, Iglesias-Perez B, Casajuana-Brunet J, Escaramis-Babiano G. [Primary health care product defined by health professionals and users]. Gac Sanit. 2006 May-Jun;20(3):209-19. doi: 10.1157/13088852. Spanish. — View Citation

Rodrigo-Banos V, Moral-Pairada MD, Gonzalez-de Paz L. A Comprehensive Assessment of Informal Caregivers of Patients in a Primary Healthcare Home-Care Program. Int J Environ Res Public Health. 2021 Nov 4;18(21):11588. doi: 10.3390/ijerph182111588. — View Citation

Sakane K, Kanzaki Y, Ito T, Hoshiga M. Motivational interviewing as a new approach to improve outcome through self-care behavioural changes in advanced heart failure patient: a case report. Eur Heart J Case Rep. 2021 Oct 1;5(10):ytab395. doi: 10.1093/ehjcr/ytab395. eCollection 2021 Oct. — View Citation

Santesmases-Masana R, Gonzalez-de Paz L, Hernandez-Martinez-Esparza E, Kostov B, Navarro-Rubio MD. Self-Care Practices of Primary Health Care Patients Diagnosed with Chronic Heart Failure: A Cross-Sectional Survey. Int J Environ Res Public Health. 2019 May 9;16(9):1625. doi: 10.3390/ijerph16091625. — View Citation

Shields GE, Wells A, Doherty P, Heagerty A, Buck D, Davies LM. Cost-effectiveness of cardiac rehabilitation: a systematic review. Heart. 2018 Sep;104(17):1403-1410. doi: 10.1136/heartjnl-2017-312809. Epub 2018 Apr 13. — View Citation

Sociedad Española de Cardiología. Registro Nacional de Unidades de Rehabilitación Cardíaca. R- EUReCa. Available from: https://secardiologia.es/riesgo/cientifico/6415-registro-nacional-de-unidades-de-rehabilitacion- cardiaca-r-eureka (accessed 30 Jan 2019).

Sokalski T, Hayden KA, Raffin Bouchal S, Singh P, King-Shier K. Motivational Interviewing and Self-care Practices in Adult Patients With Heart Failure: A Systematic Review and Narrative Synthesis. J Cardiovasc Nurs. 2020 Mar/Apr;35(2):107-115. doi: 10.1097/JCN.0000000000000627. — View Citation

Taylor RS, Dalal H, Jolly K, Moxham T, Zawada A. Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007130. doi: 10.1002/14651858.CD007130.pub2. — View Citation

Vellone E, Rebora P, Ausili D, Zeffiro V, Pucciarelli G, Caggianelli G, Masci S, Alvaro R, Riegel B. Motivational interviewing to improve self-care in heart failure patients (MOTIVATE-HF): a randomized controlled trial. ESC Heart Fail. 2020 Jun;7(3):1309-1318. doi: 10.1002/ehf2.12733. Epub 2020 Apr 28. — View Citation

Verbo E. Protocolo de rehabilitación cardiaca en pacientes con insuficiencia cardiaca (Tesis). Universidad CEU-San Pablo. 2012.

Wood DA, Kotseva K, Connolly S, Jennings C, Mead A, Jones J, Holden A, De Bacquer D, Collier T, De Backer G, Faergeman O; EUROACTION Study Group. Nurse-coordinated multidisciplinary, family-based cardiovascular disease prevention programme (EUROACTION) for patients with coronary heart disease and asymptomatic individuals at high risk of cardiovascular disease: a paired, cluster-randomised controlled trial. Lancet. 2008 Jun 14;371(9629):1999-2012. doi: 10.1016/S0140-6736(08)60868-5. — View Citation

* Note: There are 32 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Physical functional capacity Improvement in aerobic capacity and resistance, measured by a physical effort test 1st month
Primary Physical functional capacity Improvement in aerobic capacity and resistance, measured by a physical effort test 6th month
Secondary Effectiveness of secondary prevention Effectiveness of secondary prevention will be considered (Satisfied / no satisfied) with next conditions (all together):
Blood pressure values <140/90mmHg, plasma cholesterol c-LDL<70mg/dL, plasma glycosylated hemoglobin <7%. Absolute cessation or no initiation of smoking Body Mass Index in the range of 18.5-25kg/m^2.
1st month
Secondary Effectiveness of secondary prevention Effectiveness of secondary prevention will be considered (Satisfied / no satisfied) with next conditions (all together):
Blood pressure values <140/90mmHg, plasma cholesterol c-LDL<70mg/dL, plasma glycosylated hemoglobin <7%. Absolute cessation or no initiation of smoking Body Mass Index in the range of 18.5-25kg/m^2.
3rd month
Secondary Effectiveness of secondary prevention Effectiveness of secondary prevention will be considered (Satisfied / no satisfied) with next conditions (all together):
Blood pressure values <140/90mmHg, plasma cholesterol c-LDL<70mg/dL, plasma glycosylated hemoglobin <7%. Absolute cessation or no initiation of smoking Body Mass Index in the range of 18.5-25kg/m^2.
6th month
Secondary Psychological status Measured with the Psychological General Well-Being Index (PGWBI) 6th month
Secondary Perceived quality of life Physical and mental summaries of perceived quality of life measured with the generic quality of life Short Form questionnaire (SF-12). 1st month
Secondary Perceived quality of life Physical and mental summaries of perceived quality of life measured with the generic quality of life Short Form questionnaire (SF-12). 2nd month
Secondary Perceived quality of life Physical and mental summaries of perceived quality of life measured with the generic quality of life Short Form questionnaire (SF-12). 3rd month
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