VIrtual Care To Improve Outcomes and RecoverY From Heart Failure Hospitalization (VICTORY-HF)
VIrtual Care To Improve Outcomes and RecoverY From Heart Failure Hospitalization (VICTORY-HF) RCT
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Heart failure (HF) is a leading cause of mortality and morbidity across the world. Access to specialized HF clinics remains limited despite evidence that multidisciplinary HF care improves outcomes. VICTORY-HF is an international, multicentre, pragmatic randomized controlled trial evaluating whether a virtual HF clinic, in addition to routine care, improves implementation and clinical outcomes among patients recently discharged following hospitalization or urgent care visits for HF.
Participants will be randomized to a 90-day virtual HF clinic plus routine care or routine care alone. The virtual clinic will provide structured remote follow-up, monitoring, and optimization of guideline-directed medical therapy (GDMT). The trial will evaluate the effect of the intervention on the medication optimization, patient-reported health status (KCCQ-12), all-cause mortality, HF hospitalization, and emergency department visits.
The multi-centre randomized trial (CTO Project ID 4277) was preceded by a pilot randomized controlled trial (HiREB Project ID 5441) to assess the feasibility and acceptability of the intervention, refine virtual care processes, and inform the final trial protocol. Data collected during the pilot phase were limited to feasibility and process outcomes, distinct from the objectives and outcomes of the multi-center randomized controlled trial.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Harriette GC Van Spall, MD MPH
- Phone Number: 40601 (905) 521-2100
- Email: Harriette.VanSpall@phri.ca
Study Contact Backup
- Name: VICTORY-HF Project office
- Email: victory-hf@phri.ca
Study Locations
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Onatrio
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Hamilton, Onatrio, Canada, L8N 4A6
- Recruiting
- St. Joseph's Healthcare Hamilton
-
Contact:
- Katie Connolly, Dr
-
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Ontario
-
Hamilton, Ontario, Canada, L8L 2X2
- Recruiting
- Hamilton General Hospital
-
Contact:
- Harriette Van Spall, Dr
-
Hamilton, Ontario, Canada, L8V 5C2
- Recruiting
- Juravinski Hospital Cancer Centre
-
Contact:
- Serena Gundy, Dr.
-
Thunder Bay, Ontario, Canada
- Not yet recruiting
- Thunder Bay Regional Health Sciences Centre
-
Contact:
- Vahid Akbari
- Phone Number: 807-684-7580
- Email: Vahid.Akbari@tbh.net
-
Toronto, Ontario, Canada
- Recruiting
- Unity Health Toronto
-
Contact:
- Peter Mitoff
- Phone Number: 416-766-1162
- Email: Peter.Mitoff@unityhealth.to
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-
-
-
-
Monastir, Tunisia
- Recruiting
- Fattouma Bourguiba Hospital
-
Contact:
- Semir Nouira
- Phone Number: +21673106000
- Email: semir.nouira@rns.tn
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Sfax, Tunisia
- Recruiting
- Hedi Chaker Hospital
-
Contact:
- Leila Abid
- Phone Number: +21674244511
- Email: leilaabidt@yahoo.fr
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Sousse, Tunisia
- Recruiting
- Sahloul Hospital
-
Contact:
- Riadh Boukef
- Phone Number: +21673369411
- Email: riadboukef@gmail.com
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Tunis, Tunisia
- Recruiting
- Military Hospital
-
Contact:
- Wafa Fehri
- Phone Number: +21671391133
- Email: wafafehri@gmail.com
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
Adult patients ≥ 18 years old who:
Are being discharged after hospitalization or urgent visit for HF as
- a primary diagnosis or
- 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.
- Have left ventricular ejection fraction (LVEF) < 50% within the preceding 3 months.
- Have NT-proBNP of > 900 pg/ml during hospital admission or within 7 days after discharge from the ED
- Have a mailing address for patient or caregiver
- Provide verbal consent
Exclusion Criteria:
- Died or left hospital before medically advised hospital discharge
- Unable to self-assess or communicate symptoms (e.g. clinically evident dementia)
- Unable to engage with digital health technology or follow up
- Severe valve disease
- Recipient of or on waiting list for LVAD or cardiac transplant
- Complex congenital heart disease, hypertrophic obstructive cardiomyopathy, or amyloid cardiomyopathy
- 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
- Severe kidney disease (persistent eGFR < 30 mL/min/1.73m2)
- Active malignancy
- Receiving palliative care or expected life expectancy < 6 months
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Virtual HF care
Patients will receive virtual HF care to optimize medical therapies
|
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.
|
|
Other: Routine HF care
Participants will receive routine HF care
|
Care as determined by the treating physician
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Primary "Hierarchical" Composite Outcome of (Part 1):
Time Frame: 30 and 90 days
|
Target dose of beta blockers (BB), angiotensin receptor-neprilysin inhibitor (ARNI) or angiotensin-converting enzyme inhibitor (ACEi) / angiotensin receptor blocker (ARB), mineralocorticoid receptor antagonist (MRA), and sodium-glucose cotransporter-2 inhibitor (SGLT2i) at 90 days.
|
30 and 90 days
|
|
Primary "Hierarchical" Composite Outcome of (Part 2):
Time Frame: Time Frame: 30 and 90 Days
|
2. Guideline-directed medical therapy (GDMT) intensification at 30 days, defined as:
|
Time Frame: 30 and 90 Days
|
|
Primary "Hierarchical" Composite Outcome of (Part 3):
Time Frame: Time Frame: 30 and 90 days.
|
Change in health status, as measured by the Kansas City Cardiomyopathy Questionnaire-12 (KCCQ-12) summary score at 90 days.
|
Time Frame: 30 and 90 days.
|
|
Co-primary "Hierarchical" Composite Outcome of:
Time Frame: 90 and 180 days
|
These Co-Primary Hierarchical Composite Outcomes were the original Primary Outcomes for this trial. The Primary "Original" Outcome listed below applies only to the single-center pilot phase of the trial. |
90 and 180 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Guideline-Directed Medical Therapy (GDMT) use
Time Frame: 90 days
|
Achievement of at least 50% of the target doses of beta blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers or angiotensin receptor-neprilysin inhibitors, mineralocorticoid receptor antagonists, sodium-glucose cotransporter-2 inhibitors at 90 days.
|
90 days
|
|
Clinical Outcomes
Time Frame: 90 days and 180 days
|
i) Time to composite all-cause death, heart failure hospitalization, or all-cause emergency department visit at 180 days ii) Components of composite endpoint
The Secondary "Original" Outcomes listed below apply only to the single-center pilot phase. |
90 days and 180 days
|
|
Healthcare utilization
Time Frame: 90 days and 180 days
|
i) direct healthcare cost at 90 and 180 days.
ii) number of virtual and in-person clinic visits per patient in 90 days.
|
90 days and 180 days
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Harriette Van Spall, MD, McMaster University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- VICTORY-HF RCT
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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