Chronic Illness Clinical Trial
— UPHOLDSOfficial title:
Project UPHOLDS: An Optimization Pilot to Optimize An Early Palliative Care Intervention for Advanced Heart Failure
Using a highly innovative methodology, the Multiphase Optimization Strategy (MOST), the purpose of this randomized factorial pilot trial is to identify feasibility, acceptability, and preliminary efficacy of components of an intervention (UPHOLDS) to improve quality of life of older adults with advanced heart failure. Using a 2x2x2x2 factorial design, 64 adults with advanced heart failure will be randomized to receive one or more palliative care coach-delivered components, based on Ferrans' Health-Related Quality of Life Model: 1) psychoeducation on palliative care principles (4 vs. 8 sessions); 2) financial coaching (yes vs. no); 3) one-time specialty outpatient palliative care consultation (yes vs. no); and monthly follow (1 monthly follow-up call vs. monthly follow-up calls for 24 weeks).
Status | Recruiting |
Enrollment | 64 |
Est. completion date | April 1, 2026 |
Est. primary completion date | December 1, 2025 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 50 Years and older |
Eligibility | Inclusion Criteria: 1) Age =50 years; 2) Living with advanced heart failure, defined as New York Heart Association Class III-IV or American Heart Association Stage C/D; 2) Recent hospitalization with primary diagnosis of acute, decompensated heart failure (discharged < last 6 months); 3) Identifies as a member of a NIH-designated U.S. health disparity population or primary residence in a rural RUCA zip code; 4) English speaking; 5) Willingness to participate in intervention and complete data collection calls; 6) Telephone access. - Exclusion Criteria: 1) Self-reported severe mental illness (i.e., schizophrenia, bipolar disorder, or major depressive disorder), dementia, active suicidal ideation, or active substance abuse; 2) LVAD placement; 3) Non-cardiac terminal illness; 4) Previous palliative care consultation; 5) Receiving hospice - |
Country | Name | City | State |
---|---|---|---|
United States | University of Alabama at Birmingham | Birmingham | Alabama |
Lead Sponsor | Collaborator |
---|---|
University of Alabama at Birmingham | National Institute of Nursing Research (NINR) |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Feasibility of Intervention Delivery and Data Collection | Proportion of participants who complete assigned intervention components and study-related assessments. | Baseline to 24 weeks | |
Primary | Acceptability of Intervention and Study Procedures | Through qualitative interviews, participant reported experiences with the UPHOLDS intervention and trial procedures. | Baseline to 24 weeks | |
Secondary | Quality of Life using the Kansas City Cardiomyopathy Questionnaire- 12 | 12 items total; Measures changes in the quality of life, 5 domains: physical limitations, symptoms, self-efficacy, social interference, and quality of life. | 12 and 24 weeks after baseline | |
Secondary | Financial toxicity using the Comprehensive score for financial Toxicity | 10 items total; Measures level of concern regarding cost and resources. | 12 and 24 weeks after baseline | |
Secondary | Mood using the Hospital Anxiety and Depression Scale | 14 items; measures symptoms of anxiousness and depressed mood. 7 items measure anxiety (e.g., feeling tense, restless, worried) and 7 items measure depressive symptoms (e.g., cheerfulness, feeling slowed down. Subscale score ranges: 0-21; higher scores=worse anxiety or depressive symptoms. Total score range: 0-42; higher scores=worse overall distress. | 12 and 24 weeks after baseline |
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