A Study to Quantify Use of Anticoagulation to Improve Management of Atrial Fibrillation

NCT ID: NCT03382613

Last Updated: 2019-12-26

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

TERMINATED

Total Enrollment

2000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-12-29

Study Completion Date

2019-12-03

Brief Summary

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The purpose of this study is to evaluate the impact of a hospital quality improvement (QI) program on the use of guideline-recommended oral anticoagulants (OAC) in hospitalized patients with atrial fibrillation (AF) at risk for ischemic stroke. Specifically, the study will determine whether the intervention, compared to Usual Care, will result in a greater increase in the proportion of patients with AF at risk for ischemic stroke who are appropriately treated with OAC.

Detailed Description

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Conditions

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Atrial Fibrillation

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Quality Improvement (QI) Program

Hospitals assigned to the QI program arm will begin the 4-month Preparatory Phase which is designed to introduce the institutional baseline reporting tools and materials related to performance improvement, and gain insight into their gaps in treatment, followed by 15 month Implementation Phase, which will consist of education, process, and engagement activities that are targeted at the hospital and healthcare provider level and then the Measurement Period at which time hospitals will complete a final survey to document specific interventions that were successfully implemented and perform a final retrospective chart review on selected patients.

No interventions assigned to this group

Usual Care

Hospitals assigned to the Usual Care arm will not participate in the structured QI program but will continue with their standard hospital practice in treating patients with atrial fibrillation (AF) at risk for ischemic stroke. Hospitals will also complete a final survey and final retrospective chart reviews during the Measurement Period.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Inpatient hospitalization
* Primary or secondary discharge International Classification of Diseases (ICD)-9/10 diagnosis code for AF paroxysmal (I48.0), persistent (I48.1), chronic (I48.2), or unspecified (427.31, I48.91)
* Proxied Congestive Heart failure (CHA2DS2-VASC) score greater than or equal to (\>=) 2 using ICD-9 diagnosis scoring algorithm developed previously. The scoring algorithm will be expanded to include ICD-10 codes
* Discharged to home, skilled nursing facility, inpatient rehabilitation, or nursing home

Exclusion Criteria

* Presence of artificial mechanical heart valve by ICD-9/10 diagnosis or procedure code during comorbid identification period or current hospitalization
* Surgical procedure during hospitalization for open heart surgery, brain, or spine
* Intravenous heparin given on the day of discharge without warfarin/oral anticoagulant (OAC), antiplatelets, and/or aspirin
* History of left atrial appendage occlusion, including the Watchman device
* Any in-hospital (current hospitalization) bleeding identified by ICD-9/10 diagnosis codes
Minimum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Janssen Scientific Affairs, LLC

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Janssen Scientific Affairs, LLC Clinical Trial

Role: STUDY_DIRECTOR

Janssen Scientific Affairs, LLC

Locations

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Banner Thunderbird

Glendale, Arizona, United States

Site Status

Banner Desert Medical Center

Mesa, Arizona, United States

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Banner Baywood Medical Center

Mesa, Arizona, United States

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Banner Heart Hospital

Mesa, Arizona, United States

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Banner University Medical Center

Phoenix, Arizona, United States

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Banner Estrella

Phoenix, Arizona, United States

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Banner Boswell Medical Center

Sun City, Arizona, United States

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Banner Del Webb

Sun City West, Arizona, United States

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Banner University Medical Center - South (BUMC-S)

Tucson, Arizona, United States

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Banner University Medical Center - Tucson (BUMC-T)

Tucson, Arizona, United States

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Banner North Colorado Medical Center

Greeley, Colorado, United States

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Hartford Hospital

Hartford, Connecticut, United States

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The Hospital of Central Connecticut

New Britain, Connecticut, United States

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AMITA Adventist Medical Center Bolingbrook

Bolingbrook, Illinois, United States

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AMITA Alexian Brothers Medical Center

Elk Grove Village, Illinois, United States

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AMITA Adventist Medical Center Hinsdale

Hinsdale, Illinois, United States

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AMITA St. Alexius Medical Center

Hoffman Estates, Illinois, United States

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AMITA Adventist Medical Center La Grange

La Grange, Illinois, United States

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SSM Health Good Samaritan Hospital

Mount Vernon, Illinois, United States

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Ephraim McDowell Regional Medical Center

Danville, Kentucky, United States

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St. Agnes Hospital

Baltimore, Maryland, United States

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Borgess Medical Center

Kalamazoo, Michigan, United States

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Fremont Health Medical Center

Fremont, Nebraska, United States

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Penn Medicine - Princeton Health

Plainsboro, New Jersey, United States

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AtlantiCare

Pomona, New Jersey, United States

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Southside Hospital

Bay Shore, New York, United States

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Our Lady of Lourdes Hospital

Binghamton, New York, United States

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Long Island Jewish Forest Hills

Forest Hills, New York, United States

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Huntington Hospital

Huntington, New York, United States

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North Shore University Hospital

Manhasset, New York, United States

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Long Island Jewish Med Ctr

New Hyde Park, New York, United States

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Lenox Hill Hospital

New York, New York, United States

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Long Island Jewish Valley Stream

Valley Stream, New York, United States

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Samaritan Medical Center

Watertown, New York, United States

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The Jewish Hospital - Mercy

Cincinnati, Ohio, United States

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Mercy Anderson Hospital

Cincinnati, Ohio, United States

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University Hospitals Cleveland Medical Center

Cleveland, Ohio, United States

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Mercy St. Rita's Medical Center

Lima, Ohio, United States

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Mercy Lorain Regional Medical Center

Lorain, Ohio, United States

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Mercy St. Charles Hospital

Oregon, Ohio, United States

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University Hospitals Regional Hospitals

Richmond Heights, Ohio, United States

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Mercy Health St Vincent Medical Center

Toledo, Ohio, United States

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Mercy St. Anne Hospital

Toledo, Ohio, United States

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Oklahoma Health Science Center

Oklahoma City, Oklahoma, United States

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Saint Francis Hospital

Tulsa, Oklahoma, United States

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St. Luke's University Health Network

Allentown, Pennsylvania, United States

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St.Luke's University Health Network - St.Luke's Cardiology Associates

Bethlehem, Pennsylvania, United States

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Geisinger Medical Center

Danville, Pennsylvania, United States

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Geisinger Medical Center

Scranton, Pennsylvania, United States

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Geisinger Wyoming Valley

Wilkes-Barre, Pennsylvania, United States

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AnMed Health

Anderson, South Carolina, United States

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Avera McKennan Hospital

Sioux Falls, South Dakota, United States

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Hendrick Medical Center

Abilene, Texas, United States

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Methodist Dallas Medical Center

Dallas, Texas, United States

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Methodist Charlton Medical Center

Dallas, Texas, United States

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Methodist Mansfield Medical Center

Mansfield, Texas, United States

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Methodist Richardson Medical Center

Richardson, Texas, United States

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Inova Alexandria Hospital

Alexandria, Virginia, United States

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Inova Health Care Services

Falls Church, Virginia, United States

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Riverside Regional Medical Center

Newport News, Virginia, United States

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St Marys Medical Center

Huntington, West Virginia, United States

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Monongalia County General Hospital Company

Morgantown, West Virginia, United States

Site Status

Countries

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United States

Other Identifiers

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NOPRODAFL0001

Identifier Type: OTHER

Identifier Source: secondary_id

CR108407

Identifier Type: -

Identifier Source: org_study_id