A Mobile Application to Promote Self-management and Improve Outcomes in Heart Failure

NCT ID: NCT04755816

Last Updated: 2024-09-19

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-14

Study Completion Date

2023-05-17

Brief Summary

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This study will investigate the effectiveness of two contextual just-in-time adaptive interventions (JITAIs) delivered via a mobile app for heart failure patients.

Detailed Description

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The Manage HF study is a multicenter 12-week randomized controlled double-blind 2x2 factorial clinical trial. This study will investigate the effectiveness of two contextual just-in-time adaptive interventions (JITAIs) delivered via a mobile app for heart failure patients. The clinical worsening intervention targets self-management of behaviors to prevent worsening of a patient's heart failure symptoms. The dietary sodium intervention promotes lower sodium intake. Eligible participants will be randomized to the dietary sodium intervention, the clinical worsening intervention, both interventions, or no intervention in a 1:1:1:1 manner, stratified by site, gender, and HF type (HFpEF versus HFrEF).

Conditions

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Heart Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Control Group 'A'

Standard heart failure educational information.

Group Type SHAM_COMPARATOR

Educational content

Intervention Type BEHAVIORAL

Standard heart failure educational information and a daily symptom survey.

Dietary Sodium Intervention 'B'

The dietary sodium intervention facilitates lower sodium choices using tailored push notifications.

Group Type EXPERIMENTAL

Sodium intervention

Intervention Type BEHAVIORAL

The sodium dietary intervention provides the user with a tailored message to assist with making dietary choices based on sodium content when they arrive at a grocery store or restaurant.

Clinical Worsening Intervention 'C'

The clinical worsening intervention promotes self-monitoring and self-management and is linked tailored push notifications.

Group Type EXPERIMENTAL

Clinical worsening intervention

Intervention Type BEHAVIORAL

The intervention adapts to the participant's reported symptoms and provides feedback with a global health status indicator (HSI). Users will receive tailored push notification based on their HSI status.

Dietary Sodium and Clinical Worsening 'D'

Full access to all content in the control, dietary sodium, and clinical worsening interventions.

Group Type EXPERIMENTAL

Sodium intervention

Intervention Type BEHAVIORAL

The sodium dietary intervention provides the user with a tailored message to assist with making dietary choices based on sodium content when they arrive at a grocery store or restaurant.

Clinical worsening intervention

Intervention Type BEHAVIORAL

The intervention adapts to the participant's reported symptoms and provides feedback with a global health status indicator (HSI). Users will receive tailored push notification based on their HSI status.

Interventions

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Sodium intervention

The sodium dietary intervention provides the user with a tailored message to assist with making dietary choices based on sodium content when they arrive at a grocery store or restaurant.

Intervention Type BEHAVIORAL

Clinical worsening intervention

The intervention adapts to the participant's reported symptoms and provides feedback with a global health status indicator (HSI). Users will receive tailored push notification based on their HSI status.

Intervention Type BEHAVIORAL

Educational content

Standard heart failure educational information and a daily symptom survey.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Age 18 years and older at screening
2. Currently admitted or discharged from the hospital within the last 14 days with a diagnosis of acute or acute on chronic decompensated HF.
3. Based on one of the EF criteria (LVEF within 12 months of randomization. BNP or NT-proBNP criteria within 30 days prior to randomization):

* Left ventricular ejection fraction (LVEF) ≤ 40%.
* LVEF \>40% and BNP \> 175 pg/ml or NT-proBNP \> 700 pg/ml. Thresholds for NT-proBNP and BNP for LVEF \> 40% will be corrected for body mass index (BMI) using a 4% reduction per BMI unit over 25 kg/m2.
4. Have a personal physician for follow-up
5. A smartphone with a compatible Apple or Android operating system installed and able to download and use ManageHF including accepting all permissions
6. A valid email address
7. Fluent in spoken and written English

Exclusion Criteria

1. Contraindication to recommending a sodium restriction diet
2. Scheduled intervention for primary valvular heart disease will occur during the study period.
3. Cardiac resynchronization therapy (CRT) within 3 months prior to screening or current plan to implant CRT device during the study period.
4. Dialysis
5. Previous cardiac transplantation or implantation of a ventricular assistance device or similar device.
6. Listed status 1, 2 or 3 for heart transplant
7. Implantation of a ventricular assistance device is expected within 3 months after randomization
8. Non-cardiac illness with expected survival of less than 3 months
9. Discharge to a setting other than home
10. Requirement for chronic inotropic therapy (e.g. milrinone, dobutamine)
11. Inability to use Withings devices due to equipment limitations or contraindications
12. Currently pregnant or intend to become pregnant during the study period.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Michael Dorsch

Associate Professor of Clinical Pharmacy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michael Dorsch, PharmD

Role: PRINCIPAL_INVESTIGATOR

University of Michigan

Locations

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University of Alabama at Birmingham

Birmingham, Alabama, United States

Site Status

Stanford University

Stanford, California, United States

Site Status

Emory University

Atlanta, Georgia, United States

Site Status

Atlanta VA Health Care System

Decatur, Georgia, United States

Site Status

University of Michigan

Ann Arbor, Michigan, United States

Site Status

Henry Ford Hospital System

Detroit, Michigan, United States

Site Status

Washington University in St. Louis

St Louis, Missouri, United States

Site Status

University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, United States

Site Status

Virginia Commonwealth University

Richmond, Virginia, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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R01AG062582-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

HUM00181316

Identifier Type: -

Identifier Source: org_study_id

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