Heart Failure With Preserved Ejection Fraction Clinical Trial
Official title:
Virtual Visits and Distance Health to Optimize Research Trial Offerings to Heart Failure Patients: An Innovative Approach
This pilot study seeks to understand if distance health technology with virtual visits hold the key to improving access for patients who wish to partake in clinical trials clearing barriers to enrollment.
Patient participation in clinical trials is crucial to ultimately shaping change in care
delivery and development of new treatments that improve quality of life and meaningful
patient outcomes. While they hold much value, the time and resources patients must allot to
participation in protocol requirements of some clinical trials can be a barrier to trial
enrollment. With the advent of Distance Health, and Virtual Visits in particular, accompanied
by an increase in patient utilization of home computers and smart phones, patients are
swarming to different communication platforms with their care providers. We hypothesize that
distance health technology with virtual visits hold the key to improving access for patients
who wish to partake in clinical trials, clearing barriers to enrollment.
If the virtual administration of clinical trial assessments is non-inferior to the tests
regularly administered during in-clinic research related visits, this approach should be
adopted by industry-sponsored and investigator initiated research studies in heart failure
cohorts. If patients have the technological means and willingness to participate in the
study, the ability to perform these tests in the comfort of their own home will likely make
clinical trial enrollment more attractive and feasible for the patient. Furthermore,
increasing clinical trial enrollment by diminishing access barriers will improve patient care
by including a more diverse patient population in study enrollment and decrease study follow
up attrition rates.
At the baseline visit prior to consent, potential subjects will be shown the distance of
30-50 feet while in the clinic setting, in order to determine if walking distance is feasible
in the home environment. Once consented patients will complete an in-clinic baseline visit
consisting of Medical Hx review, New York Hospital Association (NYHA) assessment,
Questionnaires (EQ-5D-5L, KCCQ, Frailty Index for Elders & Mini Cog) and Functional
Assessments (Timed Up & Go and 6MWT). Patients will also receive virtual visit training.
Efforts will be made to enroll subjects from all the various NYHA class distinctions
(II,III,IV). A baseline virtual visit will be completed in the clinic setting to ensure
patient can perform the functional portion of the virtual visit in the home.
All follow-up visits will occur via virtual distance health visits. These f/u visits will
occur 2 times after the initial baseline visit (Day 7and Day 14 [+/- 3 days for all f/u time
points]. It is felt that 2 f/u visits completed in the home will reflect adequate data
regarding feasibility for performing the procedures in the home environment while also
reflecting the real time changing functional fluctuations of the patient with chronic HF. At
the initiation of each distance health f/u visit the patient's current state of health will
be assessed as well as NYHA. Questions will be asked of the patient to assess any changes in
medical condition since the previous visit. Visit procedures will be rescheduled if the
patient indicates that they are not feeling up to completing the study procedures on the
scheduled day. Patient Questionnaires(EQ-5D-5L, KCCQ & Frailty Index) and Functional
Assessments(Timed Up & Go and 6MWT) will be completed.
In order to complete the study procedures in the home during the distance health visits,
patients will be provided with 2 cones and a measuring tape for marking the distances for the
functional assessment tests.
If at anytime, the subject indicates distress or injury (ex: falling) while performing study
procedures, the research staff will call 911 on the patient's behalf.
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