Safety & Effectiveness of Drug up Titration by Nurses Specialized in Heart

Status Completed

Clinical Trial Summary

Introduction: Heart Failure (HF) generates multiple hospital admissions and mortality, which are reduced with the administration of Beta-Blocker (BB), Angiotensin Converting Enzyme Inhibitor (ACEI), Angiotensin II Receptor Blocker (ARB) and Mineralocorticoid Receptor Antagonist (MRA) drugs (Level of Evidence A). The effect is dose-dependent. Nevertheless, dosages are suboptimal. European Guidelines 2012 recommend close monitoring and up-titration of drugs by HF nurses. Trials are needed to evaluate their effectiveness and safety. Objective: To compare doses achieved by patients of BB, ACEI, ARB II and MRA in 4 months ( % relative to target doses) in the intervention group (HF nurse) and in the control group ( cardiologist), adverse events, Left Ventricular Ejection Fraction (LVEF), New York Heart Association (NYHA), 6 min. walking test, quality of life, Nt-proBNP, readmissions and mortality. Hypothesis: Non-inferiority. Design: Multicenter randomized controlled trial. New ("de novo") HF patients with LVEF ≤ 40%, NYHA II-III, without contraindications to BB of 17 Spanish hospitals will be included. Intervention: The cardiologist prescribes drugs and, driven by protocol, the HF nurse implements the up-titration. In the control group doses are decided by the cardiologist clinical support and education being provided by nurses. Variables: age, sex, education, psycho-social level, Cardio Vascular Risk Factors (CVRF), NYHA, LVEF, ischemic cardiopathy., N-terminal pro B-type natriuretic peptide (Nt-proBNP), 6min. walking test, Creatinine/Glomerular Filtration Rate (GFR), Potassium (K), haemoglobin, Blood Pressure (BP), Heart Rate (HR), mg./drug, European Heart Failure Self-Care Behaviour Scale (EHFScBS), Minnesota Living with Heart Failure questionnaire (MLHFQ), European Quality of life Scale (EQ-5D). Expected Results: If our hypothesis were confirmed, evidence would be provided on the effectiveness of this healthcare management, that could be economically evaluated in future studies. A qualitative study also will be undertaken to explore barriers and facilitators to implementation

Clinical Trial Description

No apply ;

Study Design

Related Conditions & MeSH terms

Heart Failure

Clinical Trial Details

NCT number	NCT02546856
Study type	Interventional
Source	Hospital Galdakao-Usansolo
Contact
Status	Completed
Phase	N/A
Start date	March 2015
Completion date	April 1, 2019

View Details

See also
Status	Clinical Trial	Phase
Recruiting	`NCT05650307` - CV Imaging of Metabolic Interventions
Recruiting	`NCT05196659` - Collaborative Quality Improvement (C-QIP) Study	N/A
Recruiting	`NCT05654272` - Development of CIRC Technologies
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

Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.

Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.

Safety and Effectiveness of Drug up Titration by Nurses Specialized in Heart Failure (HF) Patients — ETIFIC

Clinical Trial Summary

Clinical Trial Description

Study Design

Related Conditions & MeSH terms