Trial Outcomes & Findings for A Partnership to Translate an Evidence-based Intervention (Take Heart) for Vulnerable Older Adults With Heart Disease (NCT NCT02950818)

NCT ID: NCT02950818

Last Updated: 2022-09-23

Results Overview

This will be measured by asking participants to report the number of nights they have stayed overnight in the hospital during the past year, for something related to their own health. We will ask this at baseline and then at the 12 month mark after the completion of the baseline survey, so that we can compare the year prior to the intervention to the year they completed the intervention. In addition, when possible, we will verify self-reported hospitalizations with Electronic Medical Record (EMR) data from our partners at the Detroit Medical Center (DMC). We will only be able to look into the EMRs of those participants that are patients at the DMC. Change will be indicated by difference between count at baseline and count at follow-up.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

453 participants

Primary outcome timeframe

Baseline and 12-month follow up

Results posted on

2022-09-23

Participant Flow

Participant milestones

Participant milestones
Measure
Take Heart Self-management Program
Group and telephone-based educational program to enhance self-management of heart disease and related risk factors. Take Heart: Participants receive an evidence-based heart disease self management program consisting of a combination of five two and a half hour group sessions and telephone counseling offered by a trained facilitator employed by the Detroit Area Agency on Aging. The program is designed so that participants select an area to work on (e.g., diet, exercise, medication taking, communication with health care professionals) and receive support, information, and encouragement from group members and program facilitators, to help them reach their goals.
Waitlist Control
Control group participants will be offered the opportunity to participate in Take Heart following the conclusion of their study involvement.
Overall Study
STARTED
228
225
Overall Study
COMPLETED
161
201
Overall Study
NOT COMPLETED
67
24

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

We had missing data on sex for one participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Take Heart Self-management Program
n=228 Participants
Group and telephone-based educational program to enhance self-management of heart disease and related risk factors. Take Heart: Participants receive an evidence-based heart disease self management program consisting of a combination of five two and a half hour group sessions and telephone counseling offered by a trained facilitator employed by the Detroit Area Agency on Aging. The program is designed so that participants select an area to work on (e.g., diet, exercise, medication taking, communication with health care professionals) and receive support, information, and encouragement from group members and program facilitators, to help them reach their goals.
Waitlist Control
n=225 Participants
Control group participants will be offered the opportunity to participate in Take Heart following the conclusion of their study involvement.
Total
n=453 Participants
Total of all reporting groups
Age, Continuous
65.5 years
STANDARD_DEVIATION 9.3 • n=228 Participants
65.3 years
STANDARD_DEVIATION 8.6 • n=225 Participants
65.4 years
STANDARD_DEVIATION 9 • n=453 Participants
Sex: Female, Male
Female
155 Participants
n=228 Participants • We had missing data on sex for one participant.
179 Participants
n=224 Participants • We had missing data on sex for one participant.
334 Participants
n=452 Participants • We had missing data on sex for one participant.
Sex: Female, Male
Male
73 Participants
n=228 Participants • We had missing data on sex for one participant.
45 Participants
n=224 Participants • We had missing data on sex for one participant.
118 Participants
n=452 Participants • We had missing data on sex for one participant.
Ethnicity (NIH/OMB)
Hispanic or Latino
2 Participants
n=228 Participants
2 Participants
n=225 Participants
4 Participants
n=453 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
203 Participants
n=228 Participants
197 Participants
n=225 Participants
400 Participants
n=453 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
23 Participants
n=228 Participants
26 Participants
n=225 Participants
49 Participants
n=453 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=228 Participants
0 Participants
n=225 Participants
1 Participants
n=453 Participants
Race (NIH/OMB)
Asian
0 Participants
n=228 Participants
0 Participants
n=225 Participants
0 Participants
n=453 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=228 Participants
0 Participants
n=225 Participants
0 Participants
n=453 Participants
Race (NIH/OMB)
Black or African American
193 Participants
n=228 Participants
187 Participants
n=225 Participants
380 Participants
n=453 Participants
Race (NIH/OMB)
White
10 Participants
n=228 Participants
10 Participants
n=225 Participants
20 Participants
n=453 Participants
Race (NIH/OMB)
More than one race
20 Participants
n=228 Participants
21 Participants
n=225 Participants
41 Participants
n=453 Participants
Race (NIH/OMB)
Unknown or Not Reported
4 Participants
n=228 Participants
7 Participants
n=225 Participants
11 Participants
n=453 Participants
Region of Enrollment
United States
228 Participants
n=228 Participants
225 Participants
n=225 Participants
453 Participants
n=453 Participants
Education
<High School
23 Participants
n=226 Participants • Missing education data on participants.
30 Participants
n=225 Participants • Missing education data on participants.
53 Participants
n=451 Participants • Missing education data on participants.
Education
High School Grad or GED
55 Participants
n=226 Participants • Missing education data on participants.
56 Participants
n=225 Participants • Missing education data on participants.
111 Participants
n=451 Participants • Missing education data on participants.
Education
Some College
107 Participants
n=226 Participants • Missing education data on participants.
87 Participants
n=225 Participants • Missing education data on participants.
194 Participants
n=451 Participants • Missing education data on participants.
Education
College Graduate or Higher
41 Participants
n=226 Participants • Missing education data on participants.
52 Participants
n=225 Participants • Missing education data on participants.
93 Participants
n=451 Participants • Missing education data on participants.
Marital Status
Married/Partnered
24 Participants
n=224 Participants • Missing data on participants.
33 Participants
n=225 Participants • Missing data on participants.
57 Participants
n=449 Participants • Missing data on participants.
Marital Status
Single
200 Participants
n=224 Participants • Missing data on participants.
192 Participants
n=225 Participants • Missing data on participants.
392 Participants
n=449 Participants • Missing data on participants.
Employment Status
Employed
26 Participants
n=224 Participants • Missing data on some participants.
19 Participants
n=225 Participants • Missing data on some participants.
45 Participants
n=449 Participants • Missing data on some participants.
Employment Status
Retired
107 Participants
n=224 Participants • Missing data on some participants.
119 Participants
n=225 Participants • Missing data on some participants.
226 Participants
n=449 Participants • Missing data on some participants.
Employment Status
Unemployed
45 Participants
n=224 Participants • Missing data on some participants.
41 Participants
n=225 Participants • Missing data on some participants.
86 Participants
n=449 Participants • Missing data on some participants.
Employment Status
Other
46 Participants
n=224 Participants • Missing data on some participants.
46 Participants
n=225 Participants • Missing data on some participants.
92 Participants
n=449 Participants • Missing data on some participants.
Self-Rated Health
Excellent
2 Participants
n=227 Participants • Missing data on participant.
6 Participants
n=225 Participants • Missing data on participant.
8 Participants
n=452 Participants • Missing data on participant.
Self-Rated Health
Very Good
22 Participants
n=227 Participants • Missing data on participant.
19 Participants
n=225 Participants • Missing data on participant.
41 Participants
n=452 Participants • Missing data on participant.
Self-Rated Health
Good
79 Participants
n=227 Participants • Missing data on participant.
67 Participants
n=225 Participants • Missing data on participant.
146 Participants
n=452 Participants • Missing data on participant.
Self-Rated Health
Fair
89 Participants
n=227 Participants • Missing data on participant.
88 Participants
n=225 Participants • Missing data on participant.
177 Participants
n=452 Participants • Missing data on participant.
Self-Rated Health
Poor
35 Participants
n=227 Participants • Missing data on participant.
45 Participants
n=225 Participants • Missing data on participant.
80 Participants
n=452 Participants • Missing data on participant.
Heart Disease Diagnoses
Atrial Fibrilation
42 participants
n=228 Participants
44 participants
n=225 Participants
86 participants
n=453 Participants
Heart Disease Diagnoses
Myocardial Infarction
41 participants
n=228 Participants
38 participants
n=225 Participants
79 participants
n=453 Participants
Heart Disease Diagnoses
Valvular Disease
12 participants
n=228 Participants
22 participants
n=225 Participants
34 participants
n=453 Participants
Heart Disease Diagnoses
Pulmonary Hypertension
11 participants
n=228 Participants
7 participants
n=225 Participants
18 participants
n=453 Participants
Heart Disease Diagnoses
Angina
33 participants
n=228 Participants
44 participants
n=225 Participants
77 participants
n=453 Participants
Heart Disease Diagnoses
Congestive Heart Failure
33 participants
n=228 Participants
45 participants
n=225 Participants
78 participants
n=453 Participants
Heart Disease Diagnoses
Peripheral Vascular Disease
27 participants
n=228 Participants
26 participants
n=225 Participants
53 participants
n=453 Participants
Heart Disease Diagnoses
Other Heart Disease Condition
9 participants
n=228 Participants
6 participants
n=225 Participants
15 participants
n=453 Participants
Heart Disease Risk Factors
High Cholesterol
184 participants
n=228 Participants
170 participants
n=225 Participants
354 participants
n=453 Participants
Heart Disease Risk Factors
High Blood Pressure
210 participants
n=228 Participants
204 participants
n=225 Participants
414 participants
n=453 Participants
Heart Disease Risk Factors
Diabetes
109 participants
n=228 Participants
88 participants
n=225 Participants
197 participants
n=453 Participants
Heart Disease Risk Factors
Chronic Kidney Disease
10 participants
n=228 Participants
16 participants
n=225 Participants
26 participants
n=453 Participants
Heart Disease Risk Factors
Current Smoker
63 participants
n=228 Participants
70 participants
n=225 Participants
133 participants
n=453 Participants
Comorbidities
Depression
91 particiapnts
n=228 Participants
80 particiapnts
n=225 Participants
171 particiapnts
n=453 Participants
Comorbidities
Cancer
35 particiapnts
n=228 Participants
35 particiapnts
n=225 Participants
70 particiapnts
n=453 Participants
Comorbidities
Prediabetes
104 particiapnts
n=228 Participants
84 particiapnts
n=225 Participants
188 particiapnts
n=453 Participants
Comorbidities
Stroke
33 particiapnts
n=228 Participants
42 particiapnts
n=225 Participants
75 particiapnts
n=453 Participants
Comorbidities
Arthritis
146 particiapnts
n=228 Participants
158 particiapnts
n=225 Participants
304 particiapnts
n=453 Participants
Comorbidities
COPD
50 particiapnts
n=228 Participants
71 particiapnts
n=225 Participants
121 particiapnts
n=453 Participants
Comorbidities
Asthma
57 particiapnts
n=228 Participants
64 particiapnts
n=225 Participants
121 particiapnts
n=453 Participants
Healthcare Utilization - ED Visits
1.3 ED Visits in past 12 months
STANDARD_DEVIATION 1.7 • n=228 Participants
1.7 ED Visits in past 12 months
STANDARD_DEVIATION 3.9 • n=225 Participants
1.5 ED Visits in past 12 months
STANDARD_DEVIATION 3.1 • n=453 Participants
PROMIS-29
Physical Functioning
33.1 units on a scale
STANDARD_DEVIATION 6.8 • n=228 Participants
34.5 units on a scale
STANDARD_DEVIATION 7.1 • n=225 Participants
33.9 units on a scale
STANDARD_DEVIATION 7 • n=453 Participants
PROMIS-29
Anxiety
53.7 units on a scale
STANDARD_DEVIATION 9.4 • n=228 Participants
54.1 units on a scale
STANDARD_DEVIATION 9.7 • n=225 Participants
53.9 units on a scale
STANDARD_DEVIATION 9.5 • n=453 Participants
PROMIS-29
Depression
50.3 units on a scale
STANDARD_DEVIATION 8.2 • n=228 Participants
51.2 units on a scale
STANDARD_DEVIATION 9.3 • n=225 Participants
50.8 units on a scale
STANDARD_DEVIATION 8.8 • n=453 Participants
PROMIS-29
Fatigue
51.8 units on a scale
STANDARD_DEVIATION 9.3 • n=228 Participants
53.5 units on a scale
STANDARD_DEVIATION 9.7 • n=225 Participants
52.7 units on a scale
STANDARD_DEVIATION 9.5 • n=453 Participants
PROMIS-29
Sleep
51.9 units on a scale
STANDARD_DEVIATION 3.3 • n=228 Participants
52.4 units on a scale
STANDARD_DEVIATION 3.6 • n=225 Participants
52.2 units on a scale
STANDARD_DEVIATION 3.5 • n=453 Participants
PROMIS-29
Social
38.9 units on a scale
STANDARD_DEVIATION 9.1 • n=228 Participants
38.8 units on a scale
STANDARD_DEVIATION 8.6 • n=225 Participants
38.8 units on a scale
STANDARD_DEVIATION 8.8 • n=453 Participants
PROMIS-29
Pain Interference
57.3 units on a scale
STANDARD_DEVIATION 10.1 • n=228 Participants
58.8 units on a scale
STANDARD_DEVIATION 10 • n=225 Participants
58.1 units on a scale
STANDARD_DEVIATION 10.1 • n=453 Participants
PROMIS-29
Pain Intensity
4.9 units on a scale
STANDARD_DEVIATION 2.6 • n=228 Participants
5.5 units on a scale
STANDARD_DEVIATION 2.7 • n=225 Participants
5.3 units on a scale
STANDARD_DEVIATION 2.7 • n=453 Participants
Heart Related Symptoms
1.3 symptoms
STANDARD_DEVIATION 1.5 • n=228 Participants
1.7 symptoms
STANDARD_DEVIATION 1.5 • n=225 Participants
1.5 symptoms
STANDARD_DEVIATION 1.5 • n=453 Participants
Healthcare Utilization - Hospitalizations
1.8 Hospitalizations in past 12 months
STANDARD_DEVIATION 5 • n=228 Participants
2.4 Hospitalizations in past 12 months
STANDARD_DEVIATION 9.3 • n=225 Participants
2.1 Hospitalizations in past 12 months
STANDARD_DEVIATION 7.7 • n=453 Participants

PRIMARY outcome

Timeframe: Baseline and 12-month follow up

This will be measured by asking participants to report the number of nights they have stayed overnight in the hospital during the past year, for something related to their own health. We will ask this at baseline and then at the 12 month mark after the completion of the baseline survey, so that we can compare the year prior to the intervention to the year they completed the intervention. In addition, when possible, we will verify self-reported hospitalizations with Electronic Medical Record (EMR) data from our partners at the Detroit Medical Center (DMC). We will only be able to look into the EMRs of those participants that are patients at the DMC. Change will be indicated by difference between count at baseline and count at follow-up.

Outcome measures

Outcome measures
Measure
Take Heart Self-management Program
n=161 Participants
Group and telephone-based educational program to enhance self-management of heart disease and related risk factors. Take Heart: Participants receive an evidence-based heart disease self management program consisting of a combination of five two and a half hour group sessions and telephone counseling offered by a trained facilitator employed by the Detroit Area Agency on Aging. The program is designed so that participants select an area to work on (e.g., diet, exercise, medication taking, communication with health care professionals) and receive support, information, and encouragement from group members and program facilitators, to help them reach their goals.
Waitlist Control
n=201 Participants
Control group participants will be offered the opportunity to participate in Take Heart following the conclusion of their study involvement.
Means Difference Between Groups
Means differences at 12 months between intervention and control groups (Intervention minus control)
Hospitalizations
0.98 hospitalizations
Interval 0.98 to 1.6
1.48 hospitalizations
Interval 1.19 to 1.84

PRIMARY outcome

Timeframe: Baseline and 12 month follow up

This will be measured by asking participants to report the number of times they went to the emergency department for something related to their own health, during the past year. We will ask this at baseline and then at the 12 month mark after the completion of the baseline survey, so that we can compare the year prior to the intervention to the year they completed the intervention. In addition, when possible, we will verify self-reported Emergency Department visits with Electronic Medical Record (EMR) data from our partners at the Detroit Medical Center (DMC). We will only be able to look into the EMRs of those participants that are patients at the DMC. Change will be indicated by difference between count at baseline and count at follow-up.

Outcome measures

Outcome measures
Measure
Take Heart Self-management Program
n=161 Participants
Group and telephone-based educational program to enhance self-management of heart disease and related risk factors. Take Heart: Participants receive an evidence-based heart disease self management program consisting of a combination of five two and a half hour group sessions and telephone counseling offered by a trained facilitator employed by the Detroit Area Agency on Aging. The program is designed so that participants select an area to work on (e.g., diet, exercise, medication taking, communication with health care professionals) and receive support, information, and encouragement from group members and program facilitators, to help them reach their goals.
Waitlist Control
n=201 Participants
Control group participants will be offered the opportunity to participate in Take Heart following the conclusion of their study involvement.
Means Difference Between Groups
Means differences at 12 months between intervention and control groups (Intervention minus control)
Emergency Department Visits
2.55 ED visits
Interval 1.64 to 3.97
2.74 ED visits
Interval 1.76 to 4.27

SECONDARY outcome

Timeframe: Baseline and 12-month follow-up

Health-related quality of life (HRQOL) was measured with the PROMIS-29 (Patient-Reported Outcomes Measurement Information System-29) profile measure, which assesses depression, anxiety, pain interference, physical function, fatigue, satisfaction with social role participation, and sleep disturbance (4 items each, 5 point Likert scales). Higher values indicate poorer health. One item (11 point scale) measures pain intensity on a scale of 0 -10, 0=no pain, 10=worst pain). The T-score rescales the raw score into a standardized score with a mean of 50 and a standard deviation (SD) of 10. https://www.assessmentcenter.net/documents/PROMIS%20Profile%20Scoring%20Manual.pdf This table indicates the mean score in each domain at the 12-month follow up time point for both intervention and control groups, as well as the difference between the means of the two groups at the 12-month time point.

Outcome measures

Outcome measures
Measure
Take Heart Self-management Program
n=161 Participants
Group and telephone-based educational program to enhance self-management of heart disease and related risk factors. Take Heart: Participants receive an evidence-based heart disease self management program consisting of a combination of five two and a half hour group sessions and telephone counseling offered by a trained facilitator employed by the Detroit Area Agency on Aging. The program is designed so that participants select an area to work on (e.g., diet, exercise, medication taking, communication with health care professionals) and receive support, information, and encouragement from group members and program facilitators, to help them reach their goals.
Waitlist Control
n=201 Participants
Control group participants will be offered the opportunity to participate in Take Heart following the conclusion of their study involvement.
Means Difference Between Groups
n=362 Participants
Means differences at 12 months between intervention and control groups (Intervention minus control)
Health-related Quality of Life
Physical Functioning
33 units on a scale
Interval 31.9 to 34.2
34.1 units on a scale
Interval 33.0 to 35.2
-1.1 units on a scale
Interval -2.446 to 0.297
Health-related Quality of Life
Anxiety
54.1 units on a scale
Interval 52.5 to 55.7
54.1 units on a scale
Interval 52.6 to 55.6
0.001 units on a scale
Interval -1.907 to 1.91
Health-related Quality of Life
Pain Interference
57.6 units on a scale
Interval 55.8 to 59.4
58.9 units on a scale
Interval 57.2 to 60.6
-1.332 units on a scale
Interval -3.467 to 0.802
Health-related Quality of Life
Depression
51 units on a scale
Interval 49.4 to 52.6
51.3 units on a scale
Interval 49.8 to 52.7
-0.26 units on a scale
Interval -2.116 to 1.6
Health-related Quality of Life
Fatigue
51.3 units on a scale
Interval 49.8 to 52.9
54.2 units on a scale
Interval 52.7 to 55.6
-2.82 units on a scale
Interval -4.697 to -0.947
Health-related Quality of Life
Sleep
51.9 units on a scale
Interval 51.3 to 52.5
52.6 units on a scale
Interval 52.1 to 53.2
-0.727 units on a scale
Interval -1.431 to -0.023
Health-related Quality of Life
Social
38.9 units on a scale
Interval 34.4 to 40.5
40.1 units on a scale
Interval 28.6 to 41.5
-1.129 units on a scale
Interval -2.977 to 0.718
Health-related Quality of Life
Pain Intensity
5.1 units on a scale
Interval 4.6 to 5.5
5.4 units on a scale
Interval 4.9 to 5.8
-0.318 units on a scale
Interval -0.854 to 0.218

SECONDARY outcome

Timeframe: Baseline and 12-month follow-up

The cardiac symptom subscale of the Symptom and Health Problem Profile (Janz et al., 1999) asks about the frequency of chest pain/discomfort; shortness of breath; waking up from sleep because of chest pain or pressure; waking up from sleep because of shortness of breath or difficulty breathing; and irregular heartbeat or palpitations (not present, once or twice/week, a few times/week, once/day, several times/day) in the prior 12 months. Symptom frequency (0 to 4) was summed, yielding an overall symptom burden score that ranged from 0 to 20. Higher scores indicate worse health. Change is indicated by the difference in mean frequency from baseline to follow-up.

Outcome measures

Outcome measures
Measure
Take Heart Self-management Program
n=161 Participants
Group and telephone-based educational program to enhance self-management of heart disease and related risk factors. Take Heart: Participants receive an evidence-based heart disease self management program consisting of a combination of five two and a half hour group sessions and telephone counseling offered by a trained facilitator employed by the Detroit Area Agency on Aging. The program is designed so that participants select an area to work on (e.g., diet, exercise, medication taking, communication with health care professionals) and receive support, information, and encouragement from group members and program facilitators, to help them reach their goals.
Waitlist Control
n=201 Participants
Control group participants will be offered the opportunity to participate in Take Heart following the conclusion of their study involvement.
Means Difference Between Groups
Means differences at 12 months between intervention and control groups (Intervention minus control)
Cardiac Symptom Experience
1.96 units on a scale
Interval 1.35 to 2.58
2.74 units on a scale
Interval 2.17 to 3.32

Adverse Events

Take Heart Self-management Program

Serious events: 7 serious events
Other events: 0 other events
Deaths: 1 deaths

Waitlist Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Take Heart Self-management Program
n=228 participants at risk
Group and telephone-based educational program to enhance self-management of heart disease and related risk factors. Take Heart: Participants receive an evidence-based heart disease self management program consisting of a combination of five two and a half hour group sessions and telephone counseling offered by a trained facilitator employed by the Detroit Area Agency on Aging. The program is designed so that participants select an area to work on (e.g., diet, exercise, medication taking, communication with health care professionals) and receive support, information, and encouragement from group members and program facilitators, to help them reach their goals.
Waitlist Control
n=225 participants at risk
Control group participants will be offered the opportunity to participate in Take Heart following the conclusion of their study involvement.
Respiratory, thoracic and mediastinal disorders
ED Visit
0.44%
1/228 • Participants were assessed for adverse events from baseline through study completion, an average of 1 year.
0.00%
0/225 • Participants were assessed for adverse events from baseline through study completion, an average of 1 year.
Cardiac disorders
Heart Attack
1.8%
4/228 • Participants were assessed for adverse events from baseline through study completion, an average of 1 year.
0.00%
0/225 • Participants were assessed for adverse events from baseline through study completion, an average of 1 year.
Cardiac disorders
Stroke
0.88%
2/228 • Participants were assessed for adverse events from baseline through study completion, an average of 1 year.
0.00%
0/225 • Participants were assessed for adverse events from baseline through study completion, an average of 1 year.

Other adverse events

Adverse event data not reported

Additional Information

Cathleen Connell

University of Michigan School of Public Health

Phone: 734-647-3189

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place