VIrtual Care To Improve Outcomes and RecoverY From Heart Failure Hospitalization

NCT ID: NCT05724433

Last Updated: 2024-12-31

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

RECRUITING

Clinical Phase

NA

Total Enrollment

891 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-23

Study Completion Date

2026-12-31

Brief Summary

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The clinic visits (intervention) will continue for 90 days, which represents the follow-up period for the primary medication and health status outcomes. The co-primary clinical outcomes will be obtained at 180 days.

Detailed Description

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Heart failure (HF) is a leading cause of death, hospitalization, and healthcare system expenditure in Canada. While care in HF clinics - multidisciplinary clinics that focus on optimal management of HF - improves health outcomes in HF, there are disparities in access to such care across our province. To respond to the needs of patients and the health care system, the investigators propose to develop and implement a virtual model of care that will enable Canadians with HF to receive outpatient HF care and medical optimization remotely. The investigators hypothesize that relative to routine care alone, virtual HF clinics will improve a composite of implementation and clinical outcomes.

A pilot phase was conducted to assess the acceptability and feasibility of the intervention, assess change in health status, refine the virtual delivery process and healthcare processes, and use these to finalize protocols and guide the larger clinical trial. Data collection during the pilot phase focused on the process outcomes approved by HiREB (ID 5441).

Conditions

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Heart Failure

Keywords

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Heart Failure Randomized Controlled Trial Digital Health Knowledge Translation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is an unblinded parallel multi-center Randomized Controlled Trial (RCT) of virtual HF clinics + routine care versus routine care alone in patients discharged after a hospitalization or urgent/emergency visit for HF. Randomization will be at the level of the patients and stratified by hospital site.

Patients and clinicians will be unblinded, but those analyzing data will be blinded. We will adopt a pragmatic approach to this study.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Virtual HF care

Patients will receive virtual HF care to optimize medical therapies

Group Type EXPERIMENTAL

Virtual HF Care

Intervention Type OTHER

Patients will receive virtual visits for 3 months following hospitalization / emergency department (ED) visit for HF. Physiologic measures will be monitored remotely and therapies will be optimized.

Routine HF care

Participants will receive routine HF care

Group Type OTHER

Routine HF Care

Intervention Type OTHER

Care as determined by the treating physician

Interventions

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Virtual HF Care

Patients will receive virtual visits for 3 months following hospitalization / emergency department (ED) visit for HF. Physiologic measures will be monitored remotely and therapies will be optimized.

Intervention Type OTHER

Routine HF Care

Care as determined by the treating physician

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Adult patients ≥ 18 years old who:

1. Are being discharged after hospitalization or urgent visit for HF as

1. a primary diagnosis or
2. significant complication (prolonging length of stay) of another diagnosis OR Have been referred for an initial consult at a cardiology clinic within 1 week of hospitalization or urgent visit for HF as a primary or secondary diagnosis, as described above.
2. Have left ventricular ejection fraction (LVEF) \< 50% within the preceding 3 months.
3. Have NT-proBNP of \> 900 pg/ml during hospital admission or within 7 days after discharge from the ED
4. Have a mailing address for patient or caregiver
5. Provide verbal consent

Exclusion Criteria

1. Died or left hospital before medically advised hospital discharge
2. Unable to self-assess or communicate symptoms (e.g. clinically evident dementia)
3. Unable to engage with digital health technology or follow up
4. Severe valve disease
5. Recipient of or on waiting list for LVAD or cardiac transplant
6. Complex congenital heart disease, hypertrophic obstructive cardiomyopathy, or amyloid cardiomyopathy
7. Severe lung disease with symptoms on minimal exertion, forced expiratory volume during 1 second (FEV1) \< 1 litre, severe pulmonary hypertension with RVSP \> 60 mm Hg, or on home oxygen
8. Severe kidney disease (persistent eGFR \< 30 mL/min/1.73m2)
9. Active malignancy
10. Receiving palliative care or expected life expectancy \< 6 months
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hamilton Health Sciences Corporation

OTHER

Sponsor Role collaborator

McMaster University

OTHER

Sponsor Role collaborator

Population Health Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Harriette Van Spall

Assistant Professor of Medicine, Division of Cardiology, McMaster University, Population Health Research Institute

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Harriette Van Spall, MD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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St. Joseph's Healthcare Hamilton

Hamilton, Onatrio, Canada

Site Status RECRUITING

Hamilton General Hospital

Hamilton, Ontario, Canada

Site Status RECRUITING

Juravinski Hospital Cancer Centre

Hamilton, Ontario, Canada

Site Status RECRUITING

Thunder Bay Regional Health Sciences Centre

Thunder Bay, Ontario, Canada

Site Status NOT_YET_RECRUITING

Unity Health Toronto

Toronto, Ontario, Canada

Site Status NOT_YET_RECRUITING

Fattouma Bourguiba Hospital

Monastir, , Tunisia

Site Status RECRUITING

Hedi Chaker Hospital

Sfax, , Tunisia

Site Status RECRUITING

Sahloul Hospital

Sousse, , Tunisia

Site Status RECRUITING

Military Hospital

Tunis, , Tunisia

Site Status RECRUITING

Countries

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Canada Tunisia

Central Contacts

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Harriette GC Van Spall, MD MPH

Role: CONTACT

Phone: (905) 521-2100

Email: [email protected]

VICTORY-HF Project office

Role: CONTACT

Email: [email protected]

Facility Contacts

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Katie Connolly, Dr

Role: primary

Harriette Van Spall, Dr

Role: primary

Serena Gundy, Dr.

Role: primary

Vahid Akbari

Role: primary

Peter Mitoff

Role: primary

Semir Nouira

Role: primary

Leila Abid

Role: primary

Riadh Boukef

Role: primary

Wafa Fehri

Role: primary

Other Identifiers

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VICTORY-HF RCT

Identifier Type: -

Identifier Source: org_study_id