A Prospective Randomized Pilot Trial to Reduce Readmission for Frail Elderly Patients With Acute Decompensated Heart Failure
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- All-cause death, hospital readmission, or ED revisit
研究概览
简要总结
A randomized study designed to determine whether telephone based interventions can prevent return hospital visits for elderly and frail patients with acute symptoms of heart failure. Specifically, the intervention will improve patients ability to monitor and address self care of heart failure at home.
详细描述
Acute decompensated heart failure (ADHF) is a common illness in Canadian emergency departments (ED). The frail subset of elderly patients with ADHF is challenging to treat, use a large proportion of available resources, and are at higher risk for complications, including readmission to hospital after discharge. The investigators believe that by improving access to follow-up, optimizing self-care, and addressing the various cognitive and physical limitations of frailty, it will be possible to improve quality of life and reduce readmission rates for frail patients with ADHF.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients who presented to the ED and who are being discharged with a primary or secondary diagnosis of ADHF
- •Frailty, defined as a FRAIL score >=3/5 or Clinical Frailty Scale (CFS) score >=5/9
- •Informed consent provided by the patient or proxy
排除标准
- •Significant dementia or active delirium
- •Severe frailty, defined as a CFS score >=8/9
- •Prohibitive language barrier
- •Primary address outside of Quebec
- •Patient deemed to be palliative or moribund by treating team
研究组 & 干预措施
Control Group (Standard Care)
The control group will receive outpatient follow-up, medication advice and lifestyle guidance as prescribed at discharge from the ED or hospital.
干预措施: Control Group (Standard Care) (Other)
Intervention Group
The intervention will consist of contacting the patient 5 days post-discharge and arranging definitive outpatient follow-up and providing targeted medical and lifestyle advice based on deficient domains identified at baseline.
干预措施: Intervention Group (Behavioral)
结局指标
主要结局
All-cause death, hospital readmission, or ED revisit
时间窗: 90 days
次要结局
- Recruitment rate(90 days)
- Frailty Index(90 days)
- Informed consent validation (qualitative)(90 days)
- Self-Care Index(90 days)
- Rate of return visits to any ER for any medical issue(30 days)
- Rate of admission to hospital at 90 days(90 days)
- Heart Failure Symptom Scale(90 days)
- Incidence of adverse effects from medication(90 days)
- Attrition rate(90 days)
- All-cause death, hospital readmission, or ED revisit(1 year)
研究者
Jonathan Afilalo
Researcher
Jewish General Hospital