REmote Web Assisted Care for Heart Failure Patients With Implantable Cardioverter Defibrillators

NCT ID: NCT01589913

Last Updated: 2019-05-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

118 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-05-31

Study Completion Date

2016-08-31

Brief Summary

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Aim and Background: Although implantable cardioverter defibrillators (ICD) save lives, many ICD-patients experience psychosocial complications such as anxiety disorders, depression and reduced quality of life after ICD-implantation. A recent review has indicated great potential for psychosocial interventions to reduce anxiety and to increase exercise capacity of ICD-patients. In a previous study, the investigators showed that mailed information about technical, medical and psychological effects of ICD plus phone counseling are effective interventions for reducing anxiety, psychological distress and increasing QoL in ICD-patients \< 65 years. In a pilot study the investigators also documented promising effects of an internet based intervention with similar content.

Method: In a prospective, multicenter, multidisciplinary, half-open, part-randomized, controlled clinical trial N = 200 patients with an ICD will either receive medical care as usual or additionally attend a psychosocial prevention program via remote care. Psychosocial support will be provided utilizing the advantages of the internet. Thus, patient-centered support will be offered independent from time and location.

Outcome measures are psychometric data (questionnaires on cardiac fear, etc.), cardiac functioning, and clinical status which will be assessed up to 1 week before ICD-implantation (T0), in week 1 (T1) and within one week after (T2) the 6-weeks prevention program, and 12 months after T0 (T3). Furthermore, demographic data, personality characteristics, expectations, physiology, pro-inflammatory cytokines and cardiac status will be assessed as mediating or moderating variables.

Hypotheses: A web-based psychosocial intervention in addition to medical care as usual leads to increased QoL and reduced anxiety and depression. Secondary goals are the identification of psychosocial and medical predictors, mediators, and moderators of treatment efficacy. Moreover, differences between patients with ICDs implanted for primary vs. secondary prevention will be explored.

Conclusion: This project will evaluate the feasibility and efficacy of an internet based intervention for ICD-patients. Furthermore, the investigators aim at identifying predictors and mediators of treatment outcome. This will improve interdisciplinary care for ICD-patients; further applications for other cardiovascular disorders as well as preventive programs for heart failure seem possible.

Detailed Description

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See Summary.

Conditions

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Anxiety Depression Quality of Life

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Treatment as usual plus remote care

The same treatment as described under "treatment as usual" plus participation in the intervention "ICD-Forum".

Group Type EXPERIMENTAL

ICD-Forum

Intervention Type BEHAVIORAL

The CBT based internet program ICD-Forum is designed to increase QoL, and decrease anxiety and depression in ICD-patients. The program includes a therapist moderated asynchronous discussion group and content focused modules following a six weeks schedule:

1. Introduction to participants and online system
2. Knowledge regarding ICDs
3. Strategies for behavior change
4. Psychological models for anxiety and depression
5. Strategies to cope with avoidance, anxiety and depression
6. Resume, evaluation, resolution of open questions, goal setting, good bye

Treatment as usual

Standard information provided by hospitals on ICD-technology as well as consequences of ICD-implantation plus medical aftercare including cardiology appointments at 1, 3, and 6 months, and one year after ICD-implantation.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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ICD-Forum

The CBT based internet program ICD-Forum is designed to increase QoL, and decrease anxiety and depression in ICD-patients. The program includes a therapist moderated asynchronous discussion group and content focused modules following a six weeks schedule:

1. Introduction to participants and online system
2. Knowledge regarding ICDs
3. Strategies for behavior change
4. Psychological models for anxiety and depression
5. Strategies to cope with avoidance, anxiety and depression
6. Resume, evaluation, resolution of open questions, goal setting, good bye

Intervention Type BEHAVIORAL

Other Intervention Names

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www.icd-forum.de icd-forum.de REACH-ICD

Eligibility Criteria

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Inclusion Criteria

* Implanted ICD
* Internet access can be installed during completion of the prevention program

Exclusion Criteria

* Medical reasons preventing participation of the prevention program (e.g. emergency hospitalization) for more than one week of the program
* Suicidality (Patients with scores \> 8 on the depression subscale of the HADS will be assessed via interviews conducted by a qualified psychologist)
* Severe cognitive impairment (\< 17 points in the MMST; Kessler, J., Markowitsch, H. J. \& Denzler, P. (2000). Mini-Mental-Status-Test (MMST). Göttingen: Beltz Test GMBH. \[Deutsche Adaption\])
* Insufficient command of German to follow the intervention program
* Current ICD-10 diagnosis:
* F1x: Mental and behavioral disorders due to psychoactive substance use
* F2x: Schizophrenia, schizotypal and delusional disorders
* F30: Manic Episode
* F31: Bipolar affective disorder
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Wuerzburg

OTHER

Sponsor Role collaborator

Campus Bad Neustadt

OTHER

Sponsor Role collaborator

Hospital Rothenburg ob der Tauber

UNKNOWN

Sponsor Role collaborator

University Hospital Brandenburg

UNKNOWN

Sponsor Role collaborator

Klinikum Aschaffenburg-Alzenau

OTHER

Sponsor Role collaborator

Klinikum Bad Woerishofen

UNKNOWN

Sponsor Role collaborator

University of Leipzig

OTHER

Sponsor Role collaborator

Wuerzburg University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Paul Pauli, Prof. Dr.

Role: PRINCIPAL_INVESTIGATOR

University of Würzburg

Stefan M Schulz, Dr.

Role: PRINCIPAL_INVESTIGATOR

University of Würzburg

Locations

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Department of Cardiology, Center of Cardiovascular Medicine

Bad Neustadt an der Saale, Bavaria, Germany

Site Status

Klinik Bad Wörishofen

Bad Wörishofen, Bavaria, Germany

Site Status

Department of Internal Medicine, Krankenhaus Rothenburg ob der Tauber

Rothenburg upon Tauber, Bavaria, Germany

Site Status

University of Wuerzburg

Würzburg, Bavaria, Germany

Site Status

Wuerzburg University Hospital, Department of Medicine I (Cardiology)

Würzburg, Bavaria, Germany

Site Status

Klinikum Aschaffenburg-Alzenau

Aschaffenburg, Hesse, Germany

Site Status

Klinik für Kardiologie und Pulmologie, Medizinische Hochschule Brandenburg

Brandenburg, , Germany

Site Status

Countries

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Germany

References

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Schulz SM, Pauli P. [Internet therapy for ICD-patients]. Herzschrittmacherther Elektrophysiol. 2011 Sep;22(3):166-73. doi: 10.1007/s00399-011-0145-y. German.

Reference Type BACKGROUND
PMID: 21826541 (View on PubMed)

Schulz SM, Massa C, Grzbiela A, Dengler W, Wiedemann G, Pauli P. Implantable cardioverter defibrillator shocks are prospective predictors of anxiety. Heart Lung. 2013 Mar-Apr;42(2):105-11. doi: 10.1016/j.hrtlng.2012.08.006. Epub 2012 Oct 27.

Reference Type BACKGROUND
PMID: 23110854 (View on PubMed)

Schulz SM, Ritter O, Zniva R, Nordbeck P, Wacker C, Jack M, Groschup G, Deneke T, Puppe F, Ertl G, Angermann C, Stork S, Pauli P. Efficacy of a web-based intervention for improving psychosocial well-being in patients with implantable cardioverter-defibrillators: the randomized controlled ICD-FORUM trial. Eur Heart J. 2020 Mar 14;41(11):1203-1211. doi: 10.1093/eurheartj/ehz134.

Reference Type RESULT
PMID: 30957867 (View on PubMed)

Related Links

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http://www.icd-forum.de

Homepage for ICD-Forum, the remote care program evaluated in REACH-ICD

Other Identifiers

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UKW-CHFC-G2

Identifier Type: -

Identifier Source: org_study_id

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