- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02084992
A Study of a Technology-enabled Disease Management Program to Reduce Hospitalizations for Heart Failure (SpanCHFIII)
October 16, 2019 updated by: Tufts Medical Center
A Multicenter Randomized Controlled Evaluation of Heart Failure Disease Management Using Advanced Telecommunications Within a Diverse Provider Network: The Specialized Primary and Networked Care in HF (SPAN-CHF) III Trial
This study will randomize participants with a diagnosis of congestive heart failure and at least one risk factor for hospitalization to either a tablet computer and web based disease management program or a telephone based disease management program.
Both interventions are home based with heart failure education and symptom monitoring provided by nurse managers.
The nurse managers are in close communication with both the participants and the participants' physicians .
The components of the disease management program have been developed at Tufts Medical Center and the New England Quality Care Alliance with studies showing improved clinical outcomes, including reduced hospitalizations.
The goal of this study is to transition this successful home monitoring and disease management program to a tablet computer and web-based implementation to both improve clinical outcomes (reducing hospitalizations and improving self-perceived health status) and improve provider-patient satisfaction.
We hypothesize that the tablet computer based disease management will decrease heart failure hospitalizations.
Study Overview
Status
Completed
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
212
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
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Massachusetts
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Boston, Massachusetts, United States, 02111
- Tufts Medical Center
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Framingham, Massachusetts, United States, 01702
- MetroWest Medical Center
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Patients age ≥ 18 with a primary care provider or specialist that is participating within the Collaborative Health ACO.
- Patient able to consent
A diagnosis of heart failure with at least one of the following risk factors:
- Hospitalization for heart failure within the prior year
- NYHA class III-IV symptoms
- Most recent BNP ≥ 300 pg/mL (or Nt-proBNP ≥ 600 pg/mL) as long as within 90 days prior to enrollment
Exclusion Criteria:
- Acute myocardial infarction, PCI or CABG within 30 days before enrollment
- Planned revascularization procedures, cardiac mechanical support implantation, cardiac transplantation, or other cardiac surgery within 30 days following study randomization.
- Illness other than heart failure deemed the principal limitation to life expectancy or principal cause of disability
- Severe angina as the principal cause of limitation
- Uncorrected valvular disease, except where valvular regurgitation was considered to be secondary to severe left ventricular dilation, or where surgical correction is deemed excessively risky or declined by the patient.
- Moderate to severe dementia such that unable to participate in disease management program
- Severe visual or auditory disability such that unable to participate in disease management program
- Hospice care
- Listed for heart transplantation
- No access to a working telephone
- Homeless or no stable home environment
- Not speaking a language in which the educational documents have been translated
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Expanded technology disease management
After an initial visit where the program is introduced and education regarding adherence, methods for self-monitoring and early reporting of changes in status are reviewed, patients randomized to this arm will be given tablet computers with a web-based heart failure disease management application.
Patients will be asked to interact with the system daily with transmission of weight, heart rate, blood pressure and symptom reports to the nurse manager.
A nurse manager will check the data daily and contact patients if any parameters exceed pre-specified parameters.
Nurse managers will also touch base with the participants at regular intervals as in the control arm.
In addition, educational modules will be placed onto individual tablet computers and given to each patient.
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Tablet computers loaded with a web-based disease management program will be given to patients for the duration of the study.
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Active Comparator: telephonic disease management
After an initial visit where the program is introduced and education regarding adherence, methods for self-monitoring and early reporting of changes in status are reviewed, the nurse manager will telephone participants weekly for the first month followed by either every two weeks or monthly calls depending on clinical status with the goal of transitioning all participants to monthly calls.
During these phone calls the nurse manager will focus on identifying changes in clinical condition and education reinforcement.
Participants will be instructed to check and record their weight, heart rate and blood pressure daily and will be encouraged to call if there are any changes in their clinical status.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Number of days hospitalized for heart failure per patient-year of follow-up
Time Frame: 90 days
|
90 days
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
All Cause Mortality
Time Frame: 90 days
|
90 days
|
Cardiovascular Mortality
Time Frame: 90 days
|
90 days
|
Number of days hospitalized for cardiovascular causes at 90 days
Time Frame: 90 days
|
90 days
|
Number of days hospitalized for any cause
Time Frame: 90 days
|
90 days
|
Change in health status as assessed by the SF-12
Time Frame: 90 days
|
90 days
|
Change in self-care as assessed by the SCHFI
Time Frame: 90 days
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90 days
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Marvin A Konstam, MD, Tufts Medical Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
June 1, 2014
Primary Completion (Actual)
September 1, 2019
Study Completion (Actual)
September 1, 2019
Study Registration Dates
First Submitted
March 10, 2014
First Submitted That Met QC Criteria
March 11, 2014
First Posted (Estimate)
March 12, 2014
Study Record Updates
Last Update Posted (Actual)
October 17, 2019
Last Update Submitted That Met QC Criteria
October 16, 2019
Last Verified
October 1, 2019
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Verizon2014
- 11111 (DAIDS ES Registry Number)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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