Mainstreaming Genetic Testing for Non-Ischemic Cardiomyopathy in Western Canada: A Family-Centered and Genome-First Approach to a Common and Life-Threatening Cardiomyopathy
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 发起方
- 入组人数
- 300
- 试验地点
- 4
- 主要终点
- Uptake of genetic testing for non-ischemic cardiomyopathy (NICM)
研究概览
简要总结
Heart muscle disorders are a common cause of heart failure: a life-threatening condition that can cause dangerous abnormal heart rhythms (arrhythmia) and a buildup of fluid in the body (edema). In British Columbia (BC) and Alberta, patients with heart failure are cared for in specialized Heart Function Clinics (HFC). Providers in these clinics rapidly diagnose and treat heart failure because early treatment prevents death and disability. In some situations, particularly in young people, heart failure is caused by abnormalities in the genetic blueprint of the heart muscle - this is present at birth and passed down within families (i.e. hereditary). The investigators can diagnose this genetic abnormality by a simple blood or saliva test, which allows for better treatment of patients and diagnosis of family members to protect against heart failure and death. In BC and Alberta, people suspected of having this form of heart failure must be referred to highly specialized programs to receive genetic testing, as these healthcare systems currently do not offer genetic testing through HFCs. However, HFC providers are unaware or discouraged to refer patients because of very long waitlists of these programs. In this study, the investigators want to educate, enable, and empower HFC cardiologists to order genetic testing for heart failure. If such an intervention demonstrates success in this study, patients will no longer have to wait for up to 3 years to see a genetic specialist. Patients will be diagnosed and treated earlier, and their family members who might be in danger of having the condition can be informed more quickly. The investigators aim to leverage this study to encourage healthcare leadership to facilitate more timely access to genetic testing by showing the positive impact on health outcomes.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18 years of age or older
- •Clinical eligibility for non-ischemic cardiomyopathy/dilated cardiomyopathy (NICM/DCM) genetic testing, per existing clinical criteria in each respective province a. BC sites - presence of NICM/DCM with at least one of the following: i. Family history of NICM/DCM ii. Evidence of conduction disease iii. Arrhythmia (Ventricular or atrial) iv. Unexplained cardiomyopathy under 70 years v. Suggestive syndrome(s)
- •Alberta sites - Left ventricular ejection fraction of less than 50% and any degree of left or right ventricular dilation
排除标准
- •Previously known genetic result that explains NICM/DCM
- •Under age 18 years
- •Declines genetic testing
研究组 & 干预措施
Mainstreamed Genetic Testing through Heart Function Clinics
Mainstreamed genetic testing offered directly by the Heart Function Clinic cardiologist with video-based genetic counselling tools
干预措施: Health service delivery change (Other)
Traditional Referral Pathway for Genetic Testing
Traditional referral pathway to a specialized cardiac genetics clinic
结局指标
主要结局
Uptake of genetic testing for non-ischemic cardiomyopathy (NICM)
时间窗: Through 12 months after first participant enrollment
Proportion of eligible patients who complete clinical genetic testing for non-ischemic cardiomyopathy (NICM) following referral from a Heart Function Clinic.
Time to genotypic diagnosis
时间窗: Up to 12 months after consent for genetic testing is provided.
Time (in days) from the date informed consent for genetic testing is signed to the date genetic test results are returned.
次要结局
- Proportion of participants with a change in clinical management following genetic test results(Up to 12 months after return of genetic test results)
- Patient-reported satisfaction, knowledge, and decision quality related to genetic testing(At 12 months after first participant enrollment)
- Proportion of participants with a change to family screening recommendations following genetic test results(Up to 12 months after return of genetic test results)
研究者
Thomas Roston
Principal Investigator
Cardiology Research UBC
