Development & Testing of a Decision Aid for LVAD Placement

NCT ID: NCT02248974

Last Updated: 2019-05-31

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

98 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-02-28

Study Completion Date

2017-01-31

Brief Summary

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The goal of this project is to develop a patient-centered decision aid for decision-making about end-stage heart failure treatment. This study seeks to create a decision aid that presents outcomes, risks, projected experiences, and uncertainties about Left Ventricular Assist Device (LVAD) placement to help patients make values-based decisions about placement. The investigators propose a mixed methods design involving a literature search of clinical evidence, semi-structured patient interviews, and quantitative data from a multi-site trial of patients receiving the decision aid compared to patients not receiving the aid.

Detailed Description

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Conditions

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End-Stage Heart Failure Bridge-to-Transplant LVAD Placement (BTT) Destination Therapy LVAD Placement (DT) Refusal of LVAD Placement (Decliners) LVAD Caregivers

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

SINGLE

Participants

Study Groups

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LVAD Decision Aid

Decision aid presented to subjects was developed from patient and clinician feedback to increase patient knowledge on the risks, benefits, misconceptions or mispredictions regarding LVADs to help patients make an informed decision on accepting or declining LVAD placement.

Group Type ACTIVE_COMPARATOR

LVAD Decision Aid

Intervention Type OTHER

Decision aids are interventions or tools designed to facilitate shared decision making and patient participation in health care decisions.

This Decision Aid was designed to discuss treatment options for patients in end-stage heart failure (i.e LVAD PLACEMENT, PALLIATIVE and SUPPORTIVE CARE).

No LVAD Decision Aid

The standard education processis institution-specific and unstandardized. The education consists of viewing education pamphlets that are created by device manufacturers. The traditional informed consent process may also include viewing and manipulating the actual device and meeting a patient with a device already implanted. Additionally, the LVAD coordinator describes the device and answers any questions LVAD candidates have.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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LVAD Decision Aid

Decision aids are interventions or tools designed to facilitate shared decision making and patient participation in health care decisions.

This Decision Aid was designed to discuss treatment options for patients in end-stage heart failure (i.e LVAD PLACEMENT, PALLIATIVE and SUPPORTIVE CARE).

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* LVAD Candidates (NYHA Class III and IV patients with an acceptable surgical risk/benefit ratio for LVAD implantation and with good psychosocial support, coping mechanisms, and financial resources, as determined by "clearance" from the transplant social worker)
* LVAD Patients
* LVAD Decliners
* LVAD Caregivers

Exclusion Criteria

* subjects who lack the capacity to give informed consent
Minimum Eligible Age

30 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Methodist Hospital Research Institute

OTHER

Sponsor Role collaborator

The University of Texas Health Science Center, Houston

OTHER

Sponsor Role collaborator

M.D. Anderson Cancer Center

OTHER

Sponsor Role collaborator

INTEGRIS Baptist Medical Center

OTHER

Sponsor Role collaborator

Texas Heart Institute

OTHER

Sponsor Role collaborator

Wake Forest University Health Sciences

OTHER

Sponsor Role collaborator

The Cleveland Clinic

OTHER

Sponsor Role collaborator

Patient-Centered Outcomes Research Institute

OTHER

Sponsor Role collaborator

Ochsner Health System

OTHER

Sponsor Role collaborator

Baylor College of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Jennifer Blumenthal-Barby

Assistant Professor of Philosophy/Bioethics

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jennifer Blumenthal-Barby, PhD

Role: PRINCIPAL_INVESTIGATOR

Baylor College of Medicine

Kristin M Kostick, PhD

Role: STUDY_DIRECTOR

Baylor College of Medicine

Locations

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Ochsner Health System

New Orleans, Louisiana, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

INTEGRIS Baptist Medical Center

Oklahoma City, Oklahoma, United States

Site Status

CHI ST. Luke's - Baylor St. Lukes Medical Center / Texas Heart Institute

Houston, Texas, United States

Site Status

Houston Methodist Hospital

Houston, Texas, United States

Site Status

Baylor College of Medicine

Houston, Texas, United States

Site Status

Aurora Health Care

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

References

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Bruce CR, Delgado E, Kostick K, Grogan S, Ashrith G, Trachtenberg B, Estep JD, Bhimaraj A, Pham L, Blumenthal-Barby JS. Ventricular assist devices: a review of psychosocial risk factors and their impact on outcomes. J Card Fail. 2014 Dec;20(12):996-1003. doi: 10.1016/j.cardfail.2014.09.006. Epub 2014 Sep 17.

Reference Type BACKGROUND
PMID: 25239054 (View on PubMed)

Blumenthal-Barby, J. S., Kristin M. Kostick, Estevan D. Delgado, Robert J. Volk, Holland M. Kaplan, L. A. Wilhelms, Sheryl A. McCurdy, Jerry D. Estep, Matthias Loebe, and Courtenay R. Bruce.

Reference Type BACKGROUND

Kostick KM, Bruce CR, Minard CG, Volk RJ, Civitello A, Krim SR, Horstmanshof D, Thohan V, Loebe M, Hanna M, Bruckner BA, Blumenthal Barby JS, Estep JD. A Multisite Randomized Controlled Trial of a Patient-Centered Ventricular Assist Device Decision Aid (VADDA Trial). J Card Fail. 2018 Oct;24(10):661-671. doi: 10.1016/j.cardfail.2018.08.008. Epub 2018 Sep 7.

Reference Type DERIVED
PMID: 30195826 (View on PubMed)

Bruce CR, Minard CG, Wilhelms LA, Abraham M, Amione-Guerra J, Pham L, Grogan SD, Trachtenberg B, Smith ML, Bruckner BA, Estep JD, Kostick KM. Caregivers of Patients With Left Ventricular Assist Devices: Possible Impacts on Patients' Mortality and Interagency Registry for Mechanically Assisted Circulatory Support-Defined Morbidity Events. Circ Cardiovasc Qual Outcomes. 2017 Jan;10(1):e002879. doi: 10.1161/CIRCOUTCOMES.116.002879.

Reference Type DERIVED
PMID: 28073849 (View on PubMed)

Kostick KM, Minard CG, Wilhelms LA, Delgado E, Abraham M, Bruce CR, Estep JD, Loebe M, Volk RJ, Blumenthal-Barby JS. Development and validation of a patient-centered knowledge scale for left ventricular assist device placement. J Heart Lung Transplant. 2016 Jun;35(6):768-76. doi: 10.1016/j.healun.2016.01.015. Epub 2016 Jan 21.

Reference Type DERIVED
PMID: 26922278 (View on PubMed)

Bruce CR, Blumenthal-Barby JS, Meyers D. Benefits and Challenges of Early Introduction of Left Ventricular Assist Device Placement: A Patient-Centered Perspective. J Am Coll Cardiol. 2015 Oct 20;66(16):1762-1765. doi: 10.1016/j.jacc.2015.08.852. No abstract available.

Reference Type DERIVED
PMID: 26483098 (View on PubMed)

Blumenthal-Barby JS, Kostick KM, Delgado ED, Volk RJ, Kaplan HM, Wilhelms LA, McCurdy SA, Estep JD, Loebe M, Bruce CR. Assessment of patients' and caregivers' informational and decisional needs for left ventricular assist device placement: Implications for informed consent and shared decision-making. J Heart Lung Transplant. 2015 Sep;34(9):1182-9. doi: 10.1016/j.healun.2015.03.026. Epub 2015 Mar 31.

Reference Type DERIVED
PMID: 26087668 (View on PubMed)

Related Links

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Other Identifiers

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CDR-1306-01769

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

H-34286

Identifier Type: -

Identifier Source: org_study_id

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