Readiness for Behavior Change After a Heart Attack

NCT ID: NCT01596036

Last Updated: 2012-11-14

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

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-02-28

Study Completion Date

2012-11-30

Brief Summary

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The purpose of this study is to test if an early appointment (within 10 days) when compared to a standard appointment (5 weeks) will affect attendance at the Cardiac Rehabilitation orientation and subsequent enrollment into cardiac rehabilitation.

Detailed Description

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Cardiac Rehabilitation is central to full recovery after a myocardial infarction or a cardiac stenting procedure. Yet, this therapy is underutilized across the nation. Henry Ford currently enrolls about 42% of eligible patients. In addition, it currently takes, on average, 42 +/-26 days from hospital discharge to enrollment in rehabilitation. During this delay, there is strong tendency to return to prior habits (sedentary lifestyle, smoking, poor nutrition, etc.) that led to the myocardial infarction in the first place. This delay is both 1) unnecessary and 2) probably harmful to the patients' readiness to make changes.

The investigators seek to perform a randomized controlled trial of early (7-10 days) vs standard referral (5-6 weeks) to cardiac rehabilitation. In addition, the investigators will examine the patients' readiness to change through the first 3 months of the post-hospitalization period and correlate that to their behavior and enrollment in cardiac rehabilitation. Assessment of readiness to change will be accomplished by serial survey's, which will be administered at discharge, 2 weeks, 5 weeks, and 13 weeks after discharge.

Patients will consent to take the survey and be observed in a clinical study. However, in order to avoid the Hawthorne Effect, patients they will not initially be aware of the primary hypothesis, as the investigators strongly believe this will affect the main behavior they are trying to measure. Full patient disclosure will occur at the end of the trial.

Conditions

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Myocardial Infarction Stable Angina Coronary Artery Disease

Keywords

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cardiac rehabilitation referral enrollment timing

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants

Study Groups

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Early Appointment

Patients will receive an early appointment (within 10 days) from the time of their anticipated hospital discharge

Group Type EXPERIMENTAL

Early appointment (within 10 days)

Intervention Type BEHAVIORAL

Patients will receive an appointment to cardiac rehabilitation within 10 days from anticipated hospital discharge.

Standard Referral

Patients will receive an appointment to cardiac rehabilitation at 5 weeks from the date of their anticipated hospital discharge. A routine referral to cardiac rehabilitation will also occur in parallel. Consequently, it is possible that some patients will attend cardiac rehabilitation earlier than their assigned 5 week appointment.

Group Type PLACEBO_COMPARATOR

Routine referral (at 5 weeks)

Intervention Type OTHER

Standard Referral to Cardiac Rehabilitation

Interventions

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Early appointment (within 10 days)

Patients will receive an appointment to cardiac rehabilitation within 10 days from anticipated hospital discharge.

Intervention Type BEHAVIORAL

Routine referral (at 5 weeks)

Standard Referral to Cardiac Rehabilitation

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Stable Angina
* Myocardial infarction
* Percutaneous coronary intervention
* willingness to participate and consent for medical record review
* willingness to complete survey's

Exclusion Criteria

* Recent illicit drug use
* Unstable psychiatric condition
* Moderate or severe dementia
* Inability to follow-up
* Leaving system with plans to enroll in cardiac rehabilitation out-of-system
* Inability to exercise (amputee, severe claudication)
* Unstable medical condition that would prevent regular exercise training
* Uncorrected severe aortic stenosis or severe mitral stenosis
* Referring physician feels that exercise is contra-indicated due to safety or other patient specific factors
* CABG, LVAD, or Heart Transplant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Henry Ford Health System

OTHER

Sponsor Role lead

Responsible Party

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Quinn R Pack

Cardiology Fellow

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Quinn R Pack, MD

Role: PRINCIPAL_INVESTIGATOR

Henry Ford Hospital

Steven J Keteyian, PhD

Role: STUDY_DIRECTOR

Henry Ford Hospital

Locations

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Henry Ford Hospital

Detroit, Michigan, United States

Site Status

Countries

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United States

References

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Balady GJ, Ades PA, Bittner VA, Franklin BA, Gordon NF, Thomas RJ, Tomaselli GF, Yancy CW; American Heart Association Science Advisory and Coordinating Committee. Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical centers and beyond: a presidential advisory from the American Heart Association. Circulation. 2011 Dec 20;124(25):2951-60. doi: 10.1161/CIR.0b013e31823b21e2. Epub 2011 Nov 14. No abstract available.

Reference Type BACKGROUND
PMID: 22082676 (View on PubMed)

Russell KL, Holloway TM, Brum M, Caruso V, Chessex C, Grace SL. Cardiac rehabilitation wait times: effect on enrollment. J Cardiopulm Rehabil Prev. 2011 Nov-Dec;31(6):373-7. doi: 10.1097/HCR.0b013e318228a32f.

Reference Type BACKGROUND
PMID: 21826016 (View on PubMed)

Pack QR, Mansour M, Barboza JS, Hibner BA, Mahan MG, Ehrman JK, Vanzant MA, Schairer JR, Keteyian SJ. An early appointment to outpatient cardiac rehabilitation at hospital discharge improves attendance at orientation: a randomized, single-blind, controlled trial. Circulation. 2013 Jan 22;127(3):349-55. doi: 10.1161/CIRCULATIONAHA.112.121996. Epub 2012 Dec 18.

Reference Type DERIVED
PMID: 23250992 (View on PubMed)

Other Identifiers

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HFHS 6649

Identifier Type: -

Identifier Source: org_study_id