Congestive Heart Failure Assessment and Management in Primary Care: CHAMP
Overview
- Phase
- Phase 2
- Intervention
- Not specified
- Conditions
- Heart Failure
- Sponsor
- Hamilton Health Sciences Corporation
- Enrollment
- 170
- Locations
- 1
- Primary Endpoint
- Process-of-care composite score assessed at baseline, at 6 months for effectiveness of the intervention, and at 12 months for sustainability of the effect. The score includes assessment of:
- Last Updated
- 19 years ago
Overview
Brief Summary
Evaluation of a primary care based (family physicians) HF management strategy in patients with heart failure in the community
Detailed Description
Cluster randomized clinical trial (family physician is cluster) evaluating a primary care based heart failure management strategy
Investigators
Eligibility Criteria
Inclusion Criteria
- •Men and women, age more or equal to 65 years AND
- •Diagnosis of HF confirmed with the following criteria:
- •Previous hospital admission for HF OR
- •Definite HF confirmed with the Boston HF criteria OR
- •Possible HF confirmed with the Boston HF criteria AND evidence of left ventricular systolic dysfunction (left ventricular ejection function \<40%) on echocardiography, radionuclide angiography, or left ventricular angiogram documented in the patient's family physicians clinic chart.
Exclusion Criteria
- •Patients with terminal illness (e.g. cancer) with a life expectancy of less than one year.
- •Patients in a long-term-care facility with nursing care.
- •Patients awaiting cardiac surgery for correctable causes of HF (e.g., severe valvular disease or extensive ischemia) during the study period.
- •Patients expected to be away from the country during the intervention period for a duration of \>3 months.
- •Patients unable or refusing to sign consent.
- •Patients currently followed in the Hamilton Health Sciences HF clinic. These patients are excluded as they are currently enrolled in a HF disease management strategy.
- •Patients currently enrolled in another clinical trial.
Outcomes
Primary Outcomes
Process-of-care composite score assessed at baseline, at 6 months for effectiveness of the intervention, and at 12 months for sustainability of the effect. The score includes assessment of:
ACE-inhibitor use unless contraindicated,ACE-inhibitor dosage is at >50% of clinical trial target dose,Beta-blocker use unless contraindicated.
Each component of the score will be given one point.
Secondary Outcomes
- NYHA functional class.
- Other outcomes
- Disease specific quality of life (QOL)with Minnessota Living with Heart Failure.
- All-cause hospitalization defined as > 24-hour hospital stay including the time spent in the emergency room.
- Hospitalizations for HF: > 24-hour hospital stay including the time spent in the emergency room with clinical evidence of HF including at least one of the following: increased dyspnea on exertion, orthopnea, nocturnal dyspnea, elevated jugular venous
- Emergency room visits for deterioration of HF requiring IV or additional PO diuretics: <24-hour stay in hospital/emergency room with clinical evidence of HF.
- Referral to Hamilton Health Sciences HF clinic or other institution.
- Quality adjusted survival
- Overall costs