PCORI-1310-06998 Trial of a Decision Support Intervention for Patients and Caregivers Offered Destination Therapy Heart Assist Device
NCT ID: NCT02344576
Last Updated: 2020-03-19
Study Results
Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.
View full resultsBasic Information
Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.
COMPLETED
NA
445 participants
INTERVENTIONAL
2015-05-31
2018-02-28
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
Using feedback from patients, caregivers, clinicians, the study team made a paper and video decision aid to help people who are offered DT LVAD make this most difficult of decisions. Unlike the information that is now available, our decision aid focuses on options, fears, and the needs of caregivers, is balanced, and is paired with training for doctors and nurses on how to best talk about DT LVAD. The investigators now propose to test the effectiveness and implementation of this intervention. The investigators will apply the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) evaluative framework to a stepped-wedge, cluster-randomized, controlled trial across 6 medical centers.
Aim 1. Evaluate the Reach and Effectiveness of the DT LVAD shared decision support intervention to improve patient and caregiver experiences.
Hypothesis 1a: The intervention will reach 90% of eligible patients. Hypothesis 1b: Post-implementation, patients and caregivers will have improved decision quality (greater knowledge and higher value-treatment concordance).
Aim 2. Assess the Adoption, Implementation, and Maintenance of the DT LVAD shared decision support intervention across multiple providers and settings.
Hypothesis 2: The intervention will be: adopted by key personnel; implemented consistently; and maintained after trial completion.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
VentrAssistTM LVAD for the Treatment of Advanced Heart Failure - Destination Therapy
NCT00490321
Development & Testing of a Decision Aid for LVAD Placement
NCT02248974
VentrAssistTM LVAD as a Bridge to Cardiac Transplantation - Feasibility Trial
NCT00490347
VentrAssistTM LVAD as a Bridge to Cardiac Transplantation - Pivotal Trial
NCT00483197
Proactive Palliative Care for Patients With Ventricular Assist Devices (VAD) and Their Families
NCT01427634
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Study Design
Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.
RANDOMIZED
PARALLEL
HEALTH_SERVICES_RESEARCH
NONE
Study Groups
Review each arm or cohort in the study, along with the interventions and objectives associated with them.
Control: Usual Care
Patients and caregivers will receive the current usual education and consent process for DT LVAD at each hospital. This often means viewing consent forms and industry materials.
No interventions assigned to this group
DT LVAD Decision Support Intervention
In the intervention phase of the study, patients and caregivers will receive the new decision support intervention, which consists primarily of decision aid materials about DT LVAD. The standard consent process will also still take place, but will be supplemented with additional decision support.
DT LVAD Decision Support Intervention
Decision coaching and training of staff prior to intervention, to allow for additional decision support to patients and caregivers considering DT LVAD. Decision aid materials will be used with patients and caregivers.
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
DT LVAD Decision Support Intervention
Decision coaching and training of staff prior to intervention, to allow for additional decision support to patients and caregivers considering DT LVAD. Decision aid materials will be used with patients and caregivers.
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Caregivers of patients who are being evaluated for DT LVAD
Exclusion Criteria
* Non-English Speaking
* Unable to consent
* Prisoner
* Already implanted with DT LVAD
18 Years
ALL
No
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Patient-Centered Outcomes Research Institute
OTHER
University of Colorado, Denver
OTHER
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Larry Allen, MD, MHS
Role: PRINCIPAL_INVESTIGATOR
University of Colorado School of Medicine
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
University of Colorado School of Medicine
Aurora, Colorado, United States
St. Vincent Indianapolis Hospital
Indianapolis, Indiana, United States
Brigham and Women's Hospital
Boston, Massachusetts, United States
Mayo Clinic
Rochester, Minnesota, United States
Washington University School of Medicine in St.Louis
St Louis, Missouri, United States
Duke University Medicine
Durham, North Carolina, United States
Countries
Review the countries where the study has at least one active or historical site.
References
Explore related publications, articles, or registry entries linked to this study.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Judd SE, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Mackey RH, Magid DJ, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER 3rd, Moy CS, Mussolino ME, Neumar RW, Nichol G, Pandey DK, Paynter NP, Reeves MJ, Sorlie PD, Stein J, Towfighi A, Turan TN, Virani SS, Wong ND, Woo D, Turner MB; American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014 Jan 21;129(3):e28-e292. doi: 10.1161/01.cir.0000441139.02102.80. Epub 2013 Dec 18. No abstract available.
Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, Ikonomidis JS, Khavjou O, Konstam MA, Maddox TM, Nichol G, Pham M, Pina IL, Trogdon JG; American Heart Association Advocacy Coordinating Committee; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Cardiovascular Radiology and Intervention; Council on Clinical Cardiology; Council on Epidemiology and Prevention; Stroke Council. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail. 2013 May;6(3):606-19. doi: 10.1161/HHF.0b013e318291329a. Epub 2013 Apr 24.
Miller LW, Guglin M. Patient selection for ventricular assist devices: a moving target. J Am Coll Cardiol. 2013 Mar 26;61(12):1209-21. doi: 10.1016/j.jacc.2012.08.1029. Epub 2013 Jan 2.
Hershberger RE, Nauman D, Walker TL, Dutton D, Burgess D. Care processes and clinical outcomes of continuous outpatient support with inotropes (COSI) in patients with refractory endstage heart failure. J Card Fail. 2003 Jun;9(3):180-7. doi: 10.1054/jcaf.2003.24.
Rose EA, Gelijns AC, Moskowitz AJ, Heitjan DF, Stevenson LW, Dembitsky W, Long JW, Ascheim DD, Tierney AR, Levitan RG, Watson JT, Meier P, Ronan NS, Shapiro PA, Lazar RM, Miller LW, Gupta L, Frazier OH, Desvigne-Nickens P, Oz MC, Poirier VL; Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) Study Group. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001 Nov 15;345(20):1435-43. doi: 10.1056/NEJMoa012175.
Rogers JG, Butler J, Lansman SL, Gass A, Portner PM, Pasque MK, Pierson RN 3rd; INTrEPID Investigators. Chronic mechanical circulatory support for inotrope-dependent heart failure patients who are not transplant candidates: results of the INTrEPID Trial. J Am Coll Cardiol. 2007 Aug 21;50(8):741-7. doi: 10.1016/j.jacc.2007.03.063. Epub 2007 Aug 6.
Slaughter MS, Rogers JG, Milano CA, Russell SD, Conte JV, Feldman D, Sun B, Tatooles AJ, Delgado RM 3rd, Long JW, Wozniak TC, Ghumman W, Farrar DJ, Frazier OH; HeartMate II Investigators. Advanced heart failure treated with continuous-flow left ventricular assist device. N Engl J Med. 2009 Dec 3;361(23):2241-51. doi: 10.1056/NEJMoa0909938. Epub 2009 Nov 17.
Grady KL, Meyer PM, Dressler D, Mattea A, Chillcott S, Loo A, White-Williams C, Todd B, Ormaza S, Kaan A, Costanzo MR, Piccione W. Longitudinal change in quality of life and impact on survival after left ventricular assist device implantation. Ann Thorac Surg. 2004 Apr;77(4):1321-7. doi: 10.1016/j.athoracsur.2003.09.089.
McIlvennan CK, Magid KH, Ambardekar AV, Thompson JS, Matlock DD, Allen LA. Clinical outcomes after continuous-flow left ventricular assist device: a systematic review. Circ Heart Fail. 2014 Nov;7(6):1003-13. doi: 10.1161/CIRCHEARTFAILURE.114.001391. Epub 2014 Oct 7.
Kirklin JK, Naftel DC, Kormos RL, Stevenson LW, Pagani FD, Miller MA, Baldwin JT, Young JB. Fifth INTERMACS annual report: risk factor analysis from more than 6,000 mechanical circulatory support patients. J Heart Lung Transplant. 2013 Feb;32(2):141-56. doi: 10.1016/j.healun.2012.12.004.
Flint KM, Matlock DD, Lindenfeld J, Allen LA. Frailty and the selection of patients for destination therapy left ventricular assist device. Circ Heart Fail. 2012 Mar 1;5(2):286-93. doi: 10.1161/CIRCHEARTFAILURE.111.963215. No abstract available.
Allen LA, Stevenson LW, Grady KL, Goldstein NE, Matlock DD, Arnold RM, Cook NR, Felker GM, Francis GS, Hauptman PJ, Havranek EP, Krumholz HM, Mancini D, Riegel B, Spertus JA; American Heart Association; Council on Quality of Care and Outcomes Research; Council on Cardiovascular Nursing; Council on Clinical Cardiology; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular Surgery and Anesthesia. Decision making in advanced heart failure: a scientific statement from the American Heart Association. Circulation. 2012 Apr 17;125(15):1928-52. doi: 10.1161/CIR.0b013e31824f2173. Epub 2012 Mar 5. No abstract available.
McIlvennan CK, Allen LA. To DT or not to DT, that is the question: working toward a comprehensive, patient-centered perspective on left ventricular assist device for destination therapy. Circ Cardiovasc Qual Outcomes. 2014 Jan;7(1):13-4. doi: 10.1161/CIRCOUTCOMES.113.000762. Epub 2014 Jan 14. No abstract available.
Baker K, Flattery M, Salyer J, Haugh KH, Maltby M. Caregiving for patients requiring left ventricular assistance device support. Heart Lung. 2010 May-Jun;39(3):196-200. doi: 10.1016/j.hrtlng.2009.07.007. Epub 2009 Oct 1.
Fowler FJ Jr, Levin CA, Sepucha KR. Informing and involving patients to improve the quality of medical decisions. Health Aff (Millwood). 2011 Apr;30(4):699-706. doi: 10.1377/hlthaff.2011.0003.
McIlvennan CK, Allen LA, Nowels C, Brieke A, Cleveland JC, Matlock DD. Decision making for destination therapy left ventricular assist devices: "there was no choice" versus "I thought about it an awful lot". Circ Cardiovasc Qual Outcomes. 2014 May;7(3):374-80. doi: 10.1161/CIRCOUTCOMES.113.000729. Epub 2014 May 13.
O'Connor AM, Wennberg JE, Legare F, Llewellyn-Thomas HA, Moulton BW, Sepucha KR, Sodano AG, King JS. Toward the 'tipping point': decision aids and informed patient choice. Health Aff (Millwood). 2007 May-Jun;26(3):716-25. doi: 10.1377/hlthaff.26.3.716.
Stacey D, Legare F, Col NF, Bennett CL, Barry MJ, Eden KB, Holmes-Rovner M, Llewellyn-Thomas H, Lyddiatt A, Thomson R, Trevena L, Wu JH. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev. 2014 Jan 28;(1):CD001431. doi: 10.1002/14651858.CD001431.pub4.
Iacovetto MC, Matlock DD, McIlvennan CK, Thompson JS, Bradley W, LaRue SJ, Allen LA. Educational resources for patients considering a left ventricular assist device: a cross-sectional review of internet, print, and multimedia materials. Circ Cardiovasc Qual Outcomes. 2014 Nov;7(6):905-11. doi: 10.1161/CIRCOUTCOMES.114.000892. Epub 2014 Oct 14.
Coulter A, Stilwell D, Kryworuchko J, Mullen PD, Ng CJ, van der Weijden T. A systematic development process for patient decision aids. BMC Med Inform Decis Mak. 2013;13 Suppl 2(Suppl 2):S2. doi: 10.1186/1472-6947-13-S2-S2. Epub 2013 Nov 29.
Elwyn G, O'Connor A, Stacey D, Volk R, Edwards A, Coulter A, Thomson R, Barratt A, Barry M, Bernstein S, Butow P, Clarke A, Entwistle V, Feldman-Stewart D, Holmes-Rovner M, Llewellyn-Thomas H, Moumjid N, Mulley A, Ruland C, Sepucha K, Sykes A, Whelan T; International Patient Decision Aids Standards (IPDAS) Collaboration. Developing a quality criteria framework for patient decision aids: online international Delphi consensus process. BMJ. 2006 Aug 26;333(7565):417. doi: 10.1136/bmj.38926.629329.AE. Epub 2006 Aug 14.
Matlock DD, Spatz ES. Design and testing of tools for shared decision making. Circ Cardiovasc Qual Outcomes. 2014 May;7(3):487-92. doi: 10.1161/CIRCOUTCOMES.113.000289. Epub 2014 Apr 8. No abstract available.
Volandes AE, Ariza M, Abbo ED, Paasche-Orlow M. Overcoming educational barriers for advance care planning in Latinos with video images. J Palliat Med. 2008 Jun;11(5):700-6. doi: 10.1089/jpm.2007.0172.
Mdege ND, Man MS, Taylor Nee Brown CA, Torgerson DJ. Systematic review of stepped wedge cluster randomized trials shows that design is particularly used to evaluate interventions during routine implementation. J Clin Epidemiol. 2011 Sep;64(9):936-48. doi: 10.1016/j.jclinepi.2010.12.003. Epub 2011 Mar 16.
Glasgow RE, Klesges LM, Dzewaltowski DA, Estabrooks PA, Vogt TM. Evaluating the impact of health promotion programs: using the RE-AIM framework to form summary measures for decision making involving complex issues. Health Educ Res. 2006 Oct;21(5):688-94. doi: 10.1093/her/cyl081. Epub 2006 Aug 31.
Sepucha KR, Levin CA, Uzogara EE, Barry MJ, O'Connor AM, Mulley AG. Developing instruments to measure the quality of decisions: early results for a set of symptom-driven decisions. Patient Educ Couns. 2008 Dec;73(3):504-10. doi: 10.1016/j.pec.2008.07.009. Epub 2008 Aug 20.
Helfrich CD, Li YF, Sharp ND, Sales AE. Organizational readiness to change assessment (ORCA): development of an instrument based on the Promoting Action on Research in Health Services (PARIHS) framework. Implement Sci. 2009 Jul 14;4:38. doi: 10.1186/1748-5908-4-38.
O'Connor AM. Validation of a decisional conflict scale. Med Decis Making. 1995 Jan-Mar;15(1):25-30. doi: 10.1177/0272989X9501500105.
Brehaut JC, O'Connor AM, Wood TJ, Hack TF, Siminoff L, Gordon E, Feldman-Stewart D. Validation of a decision regret scale. Med Decis Making. 2003 Jul-Aug;23(4):281-92. doi: 10.1177/0272989X03256005.
Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96. No abstract available.
Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. doi: 10.1111/j.1600-0447.1983.tb09716.x.
EuroQol Group. EuroQol--a new facility for the measurement of health-related quality of life. Health Policy. 1990 Dec;16(3):199-208. doi: 10.1016/0168-8510(90)90421-9.
Heyland DK, Cook DJ, Rocker GM, Dodek PM, Kutsogiannis DJ, Skrobik Y, Jiang X, Day AG, Cohen SR; Canadian Researchers at the End of Life Network. The development and validation of a novel questionnaire to measure patient and family satisfaction with end-of-life care: the Canadian Health Care Evaluation Project (CANHELP) Questionnaire. Palliat Med. 2010 Oct;24(7):682-95. doi: 10.1177/0269216310373168. Epub 2010 Jul 6.
Raymer DS, Allen LA, Chaussee EL, McIlvennan CK, Thompson JS, Fairclough DL, Dunlay SM, Matlock DD, Larue SJ. Health Literacy in Patients Considering a Left Ventricular Assist Device: Findings From the DECIDE-LVAD Trial. J Card Fail. 2022 Aug;28(8):1318-1325. doi: 10.1016/j.cardfail.2022.04.009. Epub 2022 May 13.
McIlvennan CK, Jones J, Makic M, Meek PM, Chaussee E, Thompson JS, Matlock DD, Allen LA. Stress and Coping Among Family Caregivers of Patients With a Destination Therapy Left Ventricular Assist Device: A Multicenter Mixed Methods Study. Circ Heart Fail. 2021 Oct;14(10):e008243. doi: 10.1161/CIRCHEARTFAILURE.120.008243. Epub 2021 Sep 1.
Knoepke CE, Chaussee EL, Matlock DD, Thompson JS, McIlvennan CK, Ambardekar AV, Schaffer EM, Khazanie P, Scherer L, Arnold RM, Allen LA. Changes over Time in Patient Stated Values and Treatment Preferences Regarding Aggressive Therapies: Insights from the DECIDE-LVAD Trial. Med Decis Making. 2022 Apr;42(3):404-414. doi: 10.1177/0272989X211028234. Epub 2021 Jul 23.
Matlock DD, McIlvennan CK, Thompson JS, Morris MA, Venechuk G, Dunlay SM, LaRue SJ, Lewis EF, Patel CB, Blue L, Chaussee EL, Glasgow RE, Walsh MN, Allen LA. Decision Aid Implementation among Left Ventricular Assist Device Programs Participating in the DECIDE-LVAD Stepped-Wedge Trial. Med Decis Making. 2020 Apr;40(3):289-301. doi: 10.1177/0272989X20915227.
McIlvennan CK, Matlock DD, Allen LA, Thompson JS, Ranby KW, Sannes TS. Perceived Stress and Depressive Symptoms as Predictors of Decisional Conflict in Dyads Considering a Left Ventricular Assist Device. Circ Cardiovasc Qual Outcomes. 2020 Mar;13(3):e006155. doi: 10.1161/CIRCOUTCOMES.119.006155. Epub 2020 Mar 9.
Warraich HJ, Allen LA, Blue LJ, Chaussee EL, Thompson JS, McIlvennan CK, Flint KM, Matlock DD, Patel CB. Comorbidities and the decision to undergo or forego destination therapy left ventricular assist device implantation: An analysis from the Trial of a Shared Decision Support Intervention for Patients and their Caregivers Offered Destination Therapy for End-Stage Heart Failure (DECIDE-LVAD) study. Am Heart J. 2019 Jul;213:91-96. doi: 10.1016/j.ahj.2019.04.008. Epub 2019 Apr 25.
McIlvennan CK, Matlock DD, Thompson JS, Dunlay SM, Blue L, LaRue SJ, Lewis EF, Patel CB, Fairclough DL, Leister EC, Swetz KM, Baldridge V, Walsh MN, Allen LA. Caregivers of Patients Considering a Destination Therapy Left Ventricular Assist Device and a Shared Decision-Making Intervention: The DECIDE-LVAD Trial. JACC Heart Fail. 2018 Nov;6(11):904-913. doi: 10.1016/j.jchf.2018.06.019. Epub 2018 Oct 10.
Allen LA, McIlvennan CK, Thompson JS, Dunlay SM, LaRue SJ, Lewis EF, Patel CB, Blue L, Fairclough DL, Leister EC, Glasgow RE, Cleveland JC Jr, Phillips C, Baldridge V, Walsh MN, Matlock DD. Effectiveness of an Intervention Supporting Shared Decision Making for Destination Therapy Left Ventricular Assist Device: The DECIDE-LVAD Randomized Clinical Trial. JAMA Intern Med. 2018 Apr 1;178(4):520-529. doi: 10.1001/jamainternmed.2017.8713.
McIlvennan CK, Thompson JS, Matlock DD, Cleveland JC Jr, Dunlay SM, LaRue SJ, Lewis EF, Patel CB, Walsh MN, Allen LA. A Multicenter Trial of a Shared Decision Support Intervention for Patients and Their Caregivers Offered Destination Therapy for Advanced Heart Failure: DECIDE-LVAD: Rationale, Design, and Pilot Data. J Cardiovasc Nurs. 2016 Nov/Dec;31(6):E8-E20. doi: 10.1097/JCN.0000000000000343.
Provided Documents
Download supplemental materials such as informed consent forms, study protocols, or participant manuals.
Document Type: Study Protocol
Document Type: Informed Consent Form
Document Type: Statistical Analysis Plan
Related Links
Access external resources that provide additional context or updates about the study.
Decision Aids for Patients Considering Destination Therapy Left Ventricular Assist Device
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
CDR-1310-06998
Identifier Type: OTHER_GRANT
Identifier Source: secondary_id
14-2102
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.