Optimized Medico-pharmaceutical Collaboration in the Drug Management of Patients With Heart Failure

NCT ID: NCT03902028

Last Updated: 2022-01-04

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

248 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-08-02

Study Completion Date

2022-08-31

Brief Summary

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This is a controlled, randomized, open-label, multicentric study evaluating the value of coordinated medico-pharmaceutical management compared to standard management in patients with heart failure. The aim of this study is to evaluate the impact of these optimized activities on the re-hospitalization of the patient with cardiac insufficiency for a disease-related event within three months of the initial hospitalization.

Detailed Description

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Heart failure (FH) is a public health problem with an estimated prevalence of about 1.5% in developed countries. In 2013, the number of patients hospitalized in France for heart failure amounted to 165 231 and 20% of them were re-hospitalized at least once for the same reason during this year. Several factors contribute to the occurrence of cardiac decompensation (DC) : some modifiable (age, severity of IC, etiology ...) and others modifiable, such as therapeutics. Various elements could reduce the frequency of re-hospitalizations and the mortality due to this disease :

* a better knowledge of treatments by patients and consequently a better therapeutic compliance
* a better knowledge of the factors and signs of DC (low-sodium diet, weighing...)
* a better implementation of prescribing recommendations : less than 50% of patients have optimal treatment compared to ESC recommendations
* a better communication at the transition points of the patient pathway. The creation of a binomial cardiologist-clinical pharmacist during hospitalization and the maintenance of this optimized multidisciplinary follow-up within 3 months post-hospitalization is a proposal to intervene on these factors. Indeed, the clinical pharmacist (present in the care unit) works in collaboration with the medical and paramedical teams and can improve the care of patients. In the experimental group, a specific multidisciplinary consultation is planned for one month after the end of the hospitalization. A 3-month follow-up visit will be carried out by phone call to meet the criteria for readmission, mortality, quality of life, adherence and persistence of treatments.

Conditions

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Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Reinforced multidisciplinary follow-up

Entrance medication reconciliation performed by a pharmacist

* Patient compliance evaluation
* Patient quality of life evaluation
* Pharmaceutical analysis with focus on medication optimization with a specific check-list (according to ESC 2016 recommendations)
* Hospitalisation discharge medication reconciliation
* Patient pharmaceutic interview at the hospitalisation discharge
* Transmission of informations to the general practitioner and the pharmacist's patient
* Multidisciplinary consult at 1 month after hospitalisation discharge

Group Type EXPERIMENTAL

Reinforced multidisciplinary follow-up

Intervention Type OTHER

Reinforced multidisciplinary follow-up

Standard care

* Drug review by a paramedic or a pharmacist
* Pharmaceutical analysis
* Therapeutic optimisation based on the usual practices care of the cardiologic department
* Writing of the prescription given on leaving hospital based on the usual care of the department
* Treatments explanations and support to the patient on the usual care
* Transmission of the hospitalisation report to the patient general practitioner as the usual practice
* Medical consult in usual time frames (an average of 1 month after hospitalisation discharge) at the patient location of choice

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Reinforced multidisciplinary follow-up

Reinforced multidisciplinary follow-up

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient aged more than 18 years
* Adult patient admitted in cardiology department (full hospitalisation or intensive care) for heart failure no matter the type and the stage of the disease
* Person affiliated or beneficiary of a social security system
* Collection of a free, informed, express and written consent

Exclusion Criteria

* Non autonomous drug management patients and not disposing
* a present caregiver during hospitalisation
* Patients living in an institution
* Person participating in another clinical trial with an exclusion period still ongoing
* Person whose physical and/or psychological health is severely altered, and which, in the opinion of the investigator, may affect the participation's to the study
* Person deprived of his rights, person under tutorship or guardianship
* Refusal to sign the consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Montpellier

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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University Hospital of Montpellier Cardiology departments oh the Montpellier, Nîmes and Toulouse University Hospitals

Montpellier, Occitanie, France

Site Status RECRUITING

Countries

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France

Central Contacts

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Audrey CASTET-NICOLAS, MCU-PH, Pharm D, PhD

Role: CONTACT

(0)467338564 ext. +33

Nicolas CHAPET, Pharm D, PhD

Role: CONTACT

(0)467338562

Facility Contacts

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Audrey CASTET-NICOLAS, MCU-PH, Pharm D, PhD

Role: primary

(0)467338564

Nicolas CHAPET, Pharm D

Role: backup

(0)467338562

References

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Jackevicius CA, de Leon NK, Lu L, Chang DS, Warner AL, Mody FV. Impact of a Multidisciplinary Heart Failure Post-hospitalization Program on Heart Failure Readmission Rates. Ann Pharmacother. 2015 Nov;49(11):1189-96. doi: 10.1177/1060028015599637. Epub 2015 Aug 10.

Reference Type RESULT
PMID: 26259774 (View on PubMed)

Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JGF, Coats AJS, Falk V, Gonzalez-Juanatey JR, Harjola VP, Jankowska EA, Jessup M, Linde C, Nihoyannopoulos P, Parissis JT, Pieske B, Riley JP, Rosano GMC, Ruilope LM, Ruschitzka F, Rutten FH, van der Meer P; ESC Scientific Document Group. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC)Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2016 Jul 14;37(27):2129-2200. doi: 10.1093/eurheartj/ehw128. Epub 2016 May 20. No abstract available.

Reference Type RESULT
PMID: 27206819 (View on PubMed)

Available at: https://academic.oup.com/eurheartj/article/37/27/2129/1748921/2016-ESC-Guidelines-for-the-diagnosis-and. (Accessed: 12th September 2017).

Reference Type RESULT

Masters J, Morton G, Anton I, Szymanski J, Greenwood E, Grogono J, Flett AS, Cleland JG, Cowburn PJ. Specialist intervention is associated with improved patient outcomes in patients with decompensated heart failure: evaluation of the impact of a multidisciplinary inpatient heart failure team. Open Heart. 2017 Mar 8;4(1):e000547. doi: 10.1136/openhrt-2016-000547. eCollection 2017.

Reference Type RESULT
PMID: 28409010 (View on PubMed)

Van Spall HGC, Rahman T, Mytton O, Ramasundarahettige C, Ibrahim Q, Kabali C, Coppens M, Brian Haynes R, Connolly S. Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: a systematic review and network meta-analysis. Eur J Heart Fail. 2017 Nov;19(11):1427-1443. doi: 10.1002/ejhf.765. Epub 2017 Feb 24.

Reference Type RESULT
PMID: 28233442 (View on PubMed)

Lopez Cabezas C, Falces Salvador C, Cubi Quadrada D, Arnau Bartes A, Ylla Bore M, Muro Perea N, Homs Peipoch E. Randomized clinical trial of a postdischarge pharmaceutical care program vs regular follow-up in patients with heart failure. Farm Hosp. 2006 Nov-Dec;30(6):328-42. doi: 10.1016/s1130-6343(06)74004-1. English, Spanish.

Reference Type RESULT
PMID: 17298190 (View on PubMed)

Parajuli DR, Franzon J, McKinnon RA, Shakib S, Clark RA. Role of the Pharmacist for Improving Self-care and Outcomes in Heart Failure. Curr Heart Fail Rep. 2017 Apr;14(2):78-86. doi: 10.1007/s11897-017-0323-2.

Reference Type RESULT
PMID: 28233258 (View on PubMed)

Wan TTH, Terry A, Cobb E, McKee B, Tregerman R, Barbaro SDS. Strategies to Modify the Risk of Heart Failure Readmission: A Systematic Review and Meta-Analysis. Health Serv Res Manag Epidemiol. 2017 Apr 18;4:2333392817701050. doi: 10.1177/2333392817701050. eCollection 2017 Jan-Dec.

Reference Type RESULT
PMID: 28462286 (View on PubMed)

Buckley MS, Harinstein LM, Clark KB, Smithburger PL, Eckhardt DJ, Alexander E, Devabhakthuni S, Westley CA, David B, Kane-Gill SL. Impact of a clinical pharmacy admission medication reconciliation program on medication errors in "high-risk" patients. Ann Pharmacother. 2013 Dec;47(12):1599-610. doi: 10.1177/1060028013507428. Epub 2013 Oct 15.

Reference Type RESULT
PMID: 24259613 (View on PubMed)

Warden BA, Freels JP, Furuno JP, Mackay J. Pharmacy-managed program for providing education and discharge instructions for patients with heart failure. Am J Health Syst Pharm. 2014 Jan 15;71(2):134-9. doi: 10.2146/ajhp130103.

Reference Type RESULT
PMID: 24375606 (View on PubMed)

Other Identifiers

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RECHMPL18_0040

Identifier Type: -

Identifier Source: org_study_id

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