MedPath

Mobile Application for Patient Engagement and Physician-Directed Remote Management of Heart Failure

Not Applicable
Recruiting
Conditions
Heart Failure
Registration Number
NCT06750549
Lead Sponsor
University of Michigan
Brief Summary

The ENGAGE-HF mobile application tracks three key features over time: (1) heart failure health status, (2) vital signs (e.g., blood pressure, heart rate) and weight, and (3) the quality of heart failure medication therapy. Helping patients understand how these characteristics interact and change over time may improve their ability to understand and manage heart failure.

In this study, the investigators aim to evaluate whether the ENGAGE-HF mobile application, by facilitating the behavior change strategies of self-monitoring and feedback, and a clinician-facing dashboard, improves the optimization of heart failure guideline-directed medical therapies (GDMT) and quality of life.

An optional sub-study of cognitive function will invite all eligible participants enrolled in the main study to participate.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
130
Inclusion Criteria
  • Diagnosis of heart failure
  • Last left ventricular ejection fraction within 2 years < 50% based on echocardiogram, MRI, CT, or nuclear perfusion and, if no ejection fraction documented, then clinical documentation of heart failure with reduced ejection fraction
  • Currently admitted with upcoming discharge or discharged from hospital within the prior 4 weeks
  • At least two eligible heart failure therapies (guideline-recommended BB, RASI, MRA, or SGLT2i) not yet initiated or at < 50% of target dose at time of enrollment
Exclusion Criteria
  • Receives dialysis
  • Inotropic therapy after hospitalization
  • History of a prior solid organ transplant or actively listed on heart transplant waiting list
  • History of left ventricular assist device implantation
  • Cardiac amyloidosis
  • Currently pregnant or intends to become pregnant during the study period
  • Life expectancy estimated less than 6 months related to cardiac or non-cardiac comorbidities as per investigator's judgment
  • Actively enrolled in hospice or comfort care
  • Currently participating in an investigational device or drug study or having participated in such a study 30 days prior to screening
  • Subject without a compatible smartphone
  • Subject not proficient with written and spoken English
  • Any other disorder or condition that, in the opinion of the investigator would pose a risk to subject safety or interfere with the study evaluation, procedures or completion
  • Participant has diminished decision-making capacity
  • Admitted to or planned discharge to a skilled nursing facility or rehabilitation facility (acute or subacute)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Medication optimization score at 90 daysFrom enrollment to the end of participation at 90 days

The primary outcome will be the difference in the medication optimization score at 90 days between the intervention and control group. The MOS is a percent between 0 (least optimized) and 100 (most optimized), which represents the extent of medication optimization that needs to be performed. Inputs for the score include medications, vital signs, and laboratory values, and thus, the score accounts for contraindications to medical therapy titration. The score has been shown to correlate with clinical outcomes in two large randomized controlled trials.

Secondary Outcome Measures
NameTimeMethod
Kansas City Cardiomyopathy Questionnaire (KCCQ-23)Baseline and at 90 days

The secondary outcome will be heart failure symptoms as assessed by the difference between the intervention and the control groups in the 23-item Kansas City Cardiomyopathy Questionnaires (KCCQ-23) clinical summary score at 90 days.

The KCCQ-23 quantifies patients' health status over the prior 2 weeks and has extensive data supporting its validity, reliability, and sensitivity to clinical change. Scores will be transformed into a 0-100 point rating, with lower scores representing worse health status.

Trial Locations

Locations (3)

Stanford Cardiovascular Clinic

🇺🇸

Stanford, California, United States

The Johns Hopkins Hospital

🇺🇸

Baltimore, Maryland, United States

U-M Frankel Cardiovascular Center

🇺🇸

Ann Arbor, Michigan, United States

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