Enhancement of Physical Activity in Elderly Patients With Diastolic Heart Failure by a Motivational Intervention

NCT ID: NCT03402490

Last Updated: 2018-01-18

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 39 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2013-06-18
• Study Completion Date: 2015-12-08

Brief Summary

The aim of our pilot study is to evaluate the feasibility, acceptance and efficacy of motivational interviewing (MI) to support elderly patients with heart failure with preserved ejection fraction (HFpEF) in maintaining or starting physical activity (PA).

Detailed Description

Patients discharged from the Ex-DHF trial were recruited from June 2013 to December 2015 and offered participation in a controlled add-on pilot study. The treatment group (n=19) received 5 sessions of MI, each lasting 15-30 min over 6 months to enhance physical activity.

For the first two and the last sessions participants met with the psychologist-counsellor face-to-face for about 45 minutes. The remaining three sessions could be conducted via telephone or face-to-face, depending on participants' preferences, and typically lasted 15-30 minutes. Per study protocol, counsellors (physicians and psychologists trained in motivational interviewing) assisted the participants in: (1) Setting goals for their physical activity; (2) developing a plan to increase physical activities; (3) setting specific plans for the implementation of the plan; and (4) overcoming possible barriers. Participants were also asked to keep track of their daily physical activity in a diary, which counsellors then discussed with them during the sessions.

After patients had given their written informed consent, counsellors assessed all participants via structured interview and self-rating scales. At baseline only, sociodemographic information was recorded.

At baseline and at the final 6-month visit participants' motivation to be physically active in the upcoming weeks was assessed using the SSK-scale ("Sportbezogene Selbstkonkord" = sports-related self-concordance, Seelig and Fuchs 2006) to assess the self concordance of sport- and exercise-related goals.

The kind and extent of patients' daily physical activity was recorded using patient diaries. At baseline and 6 months we also conducted a symptom-limited cardiopulmonary exercise test on a bicycle ergometer, in order to assess changes in maximum rate of oxygen consumption during the last 30 seconds before the termination of the exercise (peak oxygen consumption (VO2 [ml/min/kg])) as measure of maximal exercise capacity. Participants also completed the 6-minute walk test on flat surface (6-MWT) as an additional parameter to assess submaximal exercise capacity.

Additionally, at the 6-month assessment, intervention participants filled out a questionnaire about their subjective evaluation of the counseling program.

The control group (n=20) received usual care.

Conditions

Diastolic Heart Failure

Study Design

• Allocation Method: NON_RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Motivational interviewing

Over a time span of 6 months, participants in the intervention group received up to 7 sessions of motivational counseling, lasting 15-30 minutes each, to enhance physical activity.

Group Type: EXPERIMENTAL

Motivational interviewing

Intervention Type: BEHAVIORAL

Usual care

Participants who served as controls received usual care.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Motivational interviewing

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

• preserved left ventricular systolic function (left ventricular ejection fraction >= 50%),
• echocardiographically determined diastolic dysfunction (grade ≥ 1),
• New York Heart association functional classes I, II or III,
• at least one cardiovascular risk-factor (overweight, diabetes, hypertension, smoking or hyperlipidemia)
• participation in Ex-DHF main study
• written informed consent

Exclusion Criteria

• Non-cardiac causes for heart failure-like symptoms
• Chronic obstructive pulmonary disease GOLD stages ≥II
• Anaemia (haemoglobin <11 mg/dL)
• Significant renal dysfunction (eGFR <30 mL/min/1.73 m**2 indexed to BSA)
• Significant peripheral artery disease (Fontaine ≥IIb)
• Musculoskeletal disease that contributes to reduced exercise performance
• Specific cardiomyopathy (e.g. amyloidosis)
• Haemodynamically significant valvular disorders
• Significant coronary artery disease (current angina pectoris Canadian Cardiovascular Society Class ≥II or positive stress test, myocardial infarction or coronary artery bypass graft within the last 3 months)
• Any inability or contraindication to participate in cardiopulmonary exercise testing or in an exercise programme (e.g. physiological, mental) or to supply essential information (e.g. questionnaire, diary)
• Ineffective control of resting blood pressure (≥140/90 mmHg or ≥160/100 mmHg with ≥3 antihypertensive drugs) or of resting heart rate (≥100 b.p.m.)
• Expected low adherence (e.g. by travel distance to trial site; planned absences longer than 4 weeks during follow-up) or ongoing drug abuse
• Pregnant or nursing women
• Concomitant participation in other interventional clinical trials

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK)

OTHER

Sponsor Role: collaborator

University of Göttingen

OTHER

Sponsor Role: lead

Responsible Party

Christoph Herrmann-Lingen

Prof. Dr.

Responsibility Role: PRINCIPAL_INVESTIGATOR

Other Identifiers

12345 add-on

Identifier Type: -

Identifier Source: org_study_id