Myocardial Infarction Clinical Trial
Official title:
Tailoring Post Discharge (TPD) - Bridging the Gap Through Education and Community Support
This randomized control trial seeks to better understand the educational needs of Acute Coronary Symptom (ACS) patients including the optimal timing and method of delivery as well as linkages with appropriate community resources and supports are important for cardiac patients to self-manage post hospital discharge to improve outcomes. While there is some literature of the learning needs of ACS patients, there is a paucity of research related to the timing and preferred methods of delivery. This study aims to better understand how best to tailor care for ACS patients from hospital to community. Specifically, the investigators propose a 2 phased approach to understand the needs of patients, and then to develop and deliver a tailored approach to assess, educate and support patients both in-hospital and within the community. The intervention compares 1) a virtual remote home monitoring (RHM) platform and 2) Rapid Response Nursing (RRN) staff to follow, educate and support ACS patients post hospital discharge for a period of no more than 30 days. The Primary Objective of this study is to safely transition low risk ACS patients, from hospital to home, with appropriate supports to safely self-manage in the community and to provide educational and community supports to improve post discharge outcomes of low risk ACS patients
Status | Recruiting |
Enrollment | 200 |
Est. completion date | July 30, 2025 |
Est. primary completion date | March 30, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years to 80 Years |
Eligibility | Inclusion Criteria: - All adult patients who presented with ACS to St. Boniface Hospital - Considered low risk based on cardiac risk, comorbidities, community and patient resources Exclusion Criteria: - Age less than 18 years. - Unable or unwilling to provide consent - Considered high risk for early discharge - Lives outside of Winnipeg (for Phase 2 of the study, we will only be focusing on patients that live within Winnipeg) - No internet or mobile data access |
Country | Name | City | State |
---|---|---|---|
Canada | St. Boniface Hospital | Winnipeg | Manitoba |
Lead Sponsor | Collaborator |
---|---|
St. Boniface Hospital |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Mortality - Composite outcome measure | mortality - measured as yes/no (Alive at 30 days = no) | 30-days post hospital discharge | |
Primary | Repeat MI - Composite outcome measure | repeat myocardial infarction - measured as yes/no (repeat MI at 30 days = yes) | 30-days post hospital discharge | |
Primary | Re-Admission - Composite outcome measure | re-hospitalization and emergency room/urgent care visits measured as yes/no (rehospitalization at 30 days = yes) | 30-days post hospital discharge | |
Primary | Congestive Heart Failure - Composite outcome measure | congestive heart failure - measured as yes/no (Ejection fraction < 40% is CHF) | 30-days post hospital discharge | |
Primary | Congestive Heart Failure - Composite outcome measure | serious arrhythmia (VT, VF) measured as yes/no (Arrhythmia at 30 days = yes) | 30-days post hospital discharge | |
Secondary | EQ-5D-5L - Health related Quality of Life | EQ-5D-5L - This survey will measure 5 aspects of self-reported quality of life for patients. Each component is scored from 1-5 with a total score of the tool from 5-25. Lower scores indicate better outcomes | baseline (before discharge from hospital), 2-weeks post hospital discharge, and 30 Days post hospital Discharge | |
Secondary | EQ-VAS - Health related Quality of Life | EQ-VAS - this survey measures self-report quality of life on a scale of 0-100 Higher scores indicate better self reported Quality of life | baseline (before discharge from hospital), 2-weeks post hospital discharge, and 30 Days post hospital Discharge | |
Secondary | General Anxiety Disorder (GAD) - 7 | GAD-7 this survey measures self-report anxiety symptoms with a total score from 0-21. Lower scores indicate fewer anxiety symptoms | baseline (before discharge from hospital), 2-weeks post hospital discharge, and 30 Days post hospital Discharge | |
Secondary | Patient Health Questionnaire (PHQ) - 9 | PHQ-9 this survey measures self-report depression symptoms with a total score from 0-27. Lower scores indicate fewer depressive symptoms | baseline (before discharge from hospital), 2-weeks post hospital discharge, and 30 Days post hospital Discharge |
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