Determine Return on Investment in Heart Failure Remote Monitoring Program

March 29, 2016 updated by: NCH Heatlhcare System Inc

A Prospective Randomized Controlled Trial to Determine Return on Investment in a Tablet/Smartphone-based Heart Failure Remote Monitoring Program

The study will test a hypothesis that the remote monitoring with text and email alerts sent to study subject and optional family/other caregiver (Intervention 1) will have a higher return on investment compared to remote monitoring with nurse researcher follow-up telephone communication to study subject (on Blue alerts) or study subject's healthcare professional (on Red alerts) (Intervention 2) and self-monitoring without intervention (Control).

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

The objective of this remote monitoring study is to evaluate return on investment and end-user clinical outcomes associated with the use of self-monitoring peripherals and tablet/smartphone-based Welch Allyn HealthInterlink technology without intervention (Control), HealthInterlink remote monitoring with text and email alerts sent to study subject and optional family/other caregiver (Intervention 1), and HealthInterlink remote monitoring with nurse research assistant follow-up telephone communication to study subject (on Blue alerts) or study subject's healthcare professional (on Red alerts) (Intervention 2 added to Intervention 1).

Study Type

Interventional

Enrollment (Anticipated)

163

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

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

18 years to 89 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Absence of significant vision, hearing, or other communication deficits
  • English speaking;
  • Capable and willing to give informed consent;
  • Participated in the in-patient heart failure class within the last three months. Acceptable candidate for elective, non-emergent, remote monitoring as determined by ordering physician;
  • Living in a private home;
  • Hospital admission for Heart Failure or decompensation in the previous 12 months
  • New York Heart Association (NYHA) classes II-IV, as assigned by the nurse researcher, trained by a cardiologist
  • Cardiac aetiology: ischaemic, idiopathic, hypertensive, or valvular
  • Left ventricular ejection fraction <40% s an index of systolic dysfunction, combined or not with a left ventricular filling pattern supporting the presence of diastolic dysfunction, according to the American College of Cardiology/American Heart Association Guidelines for chronic heart failure.

or

  • NYHA class II-III who had an ejection fraction >40% and evidence of diastolic left ventricular dysfunction.
  • Optional subject with a diagnosis of diabetes (indicated by HbA1c >7).

Exclusion Criteria:

  • Currently involved in other investigational clinical trials (unless permission is granted by other study PI);
  • Females who are pregnant, planning to become pregnant within 3 months, or lactating;
  • Requirement for emergent placement other than private home (subject's condition would be compromised if there is a delay in placement).
  • Myocardial infarction, revascularization or Implantable Cardioverter Defibrillator (ICD) implantation in the previous 6 months angina or objective myocardial ischaemia requiring future revascularization implanted ventricular or atrial pacemaker (except dual chamber ICD pacemakers with good sinus activity);
  • End-stage heart failure requiring regular inotropic drug infusions;
  • Chronic renal failure requiring dialysis treatment and
  • Unstable angina.

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: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Control
Control: Peripherals with HealthInterlink technology will record and transmit data, without intervention. Subject is able to view graphed data, bring the HealthInterlink tablet/smartphone to the physician's office and share data with family/other caregiver.
Device: Peripherals with HealthInterlink technology
home remote monitoring
Other Names:
  • Weight Scale
  • Welch Allyn
  • Blood Pressure monitor
  • Pulse Oximeter
  • tablet/smartphone-based technology
Experimental: Intervention 1
Intervention 1: Peripherals with HealthInterlink technology will record and transmit data and send out-of-range data (Red) alerts to subject via HealthInterlink tablet/smartphone and also text/email to family/other caregiver, and nonconformity (Blue) alerts to subject's personal text/email and also text/email to family/other caregiver.
Device: Peripherals with HealthInterlink technology
home remote monitoring
Other Names:
  • Weight Scale
  • Welch Allyn
  • Blood Pressure monitor
  • Pulse Oximeter
  • tablet/smartphone-based technology
Experimental: Intervention 2
Intervention 2: Peripherals with HealthInterlink technology will record and transmit data and send out-of-range data (Red) alerts to subject via HealthInterlink tablet/smartphone and also text/email to family/other caregiver, and nonconformity (Blue) alerts to subject's personal text/email and also text/email to family/other caregiver, and a call will be placed by the nurse research assistant to study subject (on Blue alerts) or study subject's healthcare professional (on Red alerts). The physicians will have access to the subject's data on a web-based program.
Device: Peripherals with HealthInterlink technology
home remote monitoring
Other Names:
  • Weight Scale
  • Welch Allyn
  • Blood Pressure monitor
  • Pulse Oximeter
  • tablet/smartphone-based technology

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of subjects with unplanned re- hospitalization (heart failure-related and other hospitalization)
Time Frame: 31 days
31 days post discharge with a heart failure-related hospital re-hospitalization.
31 days

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Communication with healthcare provider or emergency department
Time Frame: 31 days
Communication that resulted in unplanned healthcare provider office visits or visit to emergency department
31 days
Number of non-conformity issues
Time Frame: 31 days
Number of non-conformity telephone reminder texts, emails, and/or calls.
31 days
Health-related quality of life Questionnaire
Time Frame: 31 days
Health-related quality of life
31 days
Subject satisfaction Questionnaire
Time Frame: 31 days
Subject satisfaction for peripherals and HealthInterlink tablet/ smartphone judged to be reliable and robust, ease of use, time to complete testing and questionnaire, benefit that promoted better health
31 days
Physician satisfaction Questionnaire
Time Frame: 31 days
Physician satisfaction for peripherals and HealthInterlink tablet/ smartphone judged to be reliable and robust, ease of use of software, benefit that promoted better communication with subject.
31 days
Cost of system and intervention per subjects
Time Frame: 31 days
Economic viability of remote monitoring program based on daily cost of system and intervention per subjects in comparison with control and treatment groups.
31 days

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number and type of incidents
Time Frame: 31 days
Number and type of incident based on predefined criteria from the remote monitoring data (clinical signs and symptoms related to worsening of cardiac insufficiency or to its complications).
31 days
Subject attrition
Time Frame: 31 days
Rate of subjects discontinuing the study due to Patient Request, Patient Complaint, Patient Transferred to higher level of care (ACLF, SNF), Patient Hospitalized, Physician Request Monitoring No Longer Needed (Resolution of Disease Process, Change in Treatment), Physician Complaint, Patient Expired, Patient all-cause mortality or Without other identifiable cause.
31 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

NCH Heatlhcare System Inc

Collaborators

Welch Allyn

Investigators

  • Principal Investigator: Theresa Morrison, PhD, NCH Healthcare System Inc

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

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, 2015

Primary Completion (Anticipated)

June 1, 2017

Study Completion (Anticipated)

August 1, 2017

Study Registration Dates

First Submitted

June 12, 2015

First Submitted That Met QC Criteria

June 17, 2015

First Posted (Estimate)

June 18, 2015

Study Record Updates

Last Update Posted (Estimate)

March 31, 2016

Last Update Submitted That Met QC Criteria

March 29, 2016

Last Verified

March 1, 2016

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 15-001

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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