Reducing Cognitive Impairment by Management of Heart Failure as a Modifiable Risk Factor

NCT ID: NCT06088212

Last Updated: 2024-08-12

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

168 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-01

Study Completion Date

2026-07-31

Brief Summary

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This study will test the feasibility and effectiveness of an innovative model of care for cognitively impaired patients with heart failure. This program aims to improve cognition, reduce dementia risk and cardiovascular events, and will be supported by innovative digital technology for wide scale rollout and implementation. Findings from this research will transform the way healthcare is delivered to cognitively impaired patients with heart disease who have a very high risk of developing dementia.

Detailed Description

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Conditions

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Heart Failure Cognitive Impairment Dementia Left Ventricular Dysfunction Cognitive Change Cognitive Decline

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Usual care

Usual care patients will continue with the hospital follow-up plan and routine preventive care after hospital discharge.

Group Type NO_INTERVENTION

No interventions assigned to this group

Intervention

Intervention patients will receive a disease management program in addition to the usual care.

Group Type EXPERIMENTAL

Disease management program

Intervention Type OTHER

The components of our DMP include:

1. Intensive post-discharge education
2. Home surveillance of signs and symptoms will be reviewed (weekly in the first month and monthly thereafter) in a telehealth consultation with patient and/or carer.
3. Medical treatment involves a planned up-titration of cardioprotective medications that will proceed in the absence of advice from the general practitioner (GP) to the contrary. Close observation and frequent appointments are organised by the nurse with the patient's GP during up-titration period.
4. Exercise program delivered by an exercise physiologist
5. Maintenance phase of the DMP: During this maintenance phase, Intervention patients should have been fully transitioned to home care where they are managed by their GP at optimal doses of their medications. Repeated education and exercise guidance will continue with the carer, supported by our cardiac nurse and exercise physiologist via telehealth consultation bimonthly.

Interventions

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Disease management program

The components of our DMP include:

1. Intensive post-discharge education
2. Home surveillance of signs and symptoms will be reviewed (weekly in the first month and monthly thereafter) in a telehealth consultation with patient and/or carer.
3. Medical treatment involves a planned up-titration of cardioprotective medications that will proceed in the absence of advice from the general practitioner (GP) to the contrary. Close observation and frequent appointments are organised by the nurse with the patient's GP during up-titration period.
4. Exercise program delivered by an exercise physiologist
5. Maintenance phase of the DMP: During this maintenance phase, Intervention patients should have been fully transitioned to home care where they are managed by their GP at optimal doses of their medications. Repeated education and exercise guidance will continue with the carer, supported by our cardiac nurse and exercise physiologist via telehealth consultation bimonthly.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Hospitalised with HF as primary or secondary diagnosis.
2. At least mild cognitive impairment (CI) based on Montreal Cognitive Assessment (MoCA) on hospital discharge.

Exclusion Criteria

1. Unable to provide written consent; requiring palliative care; or participating in another RCT
2. Recovery of cognitive function shortly after hospital discharge: to ensure that we only include patients with "true" CI, any patients with a repeated MoCA\>25 at 2 weeks post-discharge will be excluded.
3. Terminal illness (eg. cancer) that may influence 12-month prognosis.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Baker Heart and Diabetes Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thomas H Marwick, MBBS PhD MPH

Role: PRINCIPAL_INVESTIGATOR

Baker Heart and Diabetes Institute

Locations

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Menzies Institute for Medical Research

Hobart, Tasmania, Australia

Site Status RECRUITING

Countries

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Australia

Central Contacts

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Quan Huynh

Role: CONTACT

610385321833

Facility Contacts

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Kristyn Whitmore

Role: primary

Other Identifiers

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P8510

Identifier Type: -

Identifier Source: org_study_id

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