Engaging Patients in Heart Failure Management

An interventional study to empower congestive heart failure patients who have a cardiac resynchronization therapy-cardiac implantable electronic device (CRT-CIED) by using a personal health record (PHR) to directly message them their device data and send alerts based on percent left ventricular pacing.

Study Overview

• Status: Completed
• Conditions: Congestive Heart Failure
• Intervention / Treatment: Other: PHR Messaging

Detailed Description

An interventional study to empower congestive heart failure patients who have a cardiac resynchronization therapy-cardiac implantable electronic device (CRT-CIED) by using a personal health record (PHR) to directly message them their device data and send alerts based on percent left ventricular pacing.

There will be three phases in this study. In the first phase the investigators will employ a user-centered design approach to better understand what types of information that patients who have a remotely monitored CRT-CIED would find beneficial towards understanding and managing their disease. The investigators also hope to uncover expectations for alert mechanisms and two-way messaging between provider and patient around CIED remote monitoring data. In the second phase the investigators will implement the PHR intervention as designed in phase 1. In the third phase of this study, the investigators will test the PHR intervention in a single arm, 6-month trial.

A maximum of 120 participants (including patients and their caregiver, partner, and/or support persons) will be enrolled in the focus groups for phase 1. A maximum of 10 patients will be enrolled in the design session to follow in phase 1. After building the intervention in phase 2, a maximum of 30 patients will be enrolled in the technology trial for phase 3. Enrollment is projected to be complete within six months for phase 1, and within one year for phase 3.

In phase 3, adult subjects (N=30) with a diagnosis of congestive heart failure undergoing chronic resynchronization therapy through their CIED will receive interventional messaging through their PHR regarding percent left ventricular pacing.

The study duration will commence at the time of informed consent documentation during the first focus group and conclude at the time of the last patient visit during the technology trial.

Impact of PHR messaging will be evaluated by timeliness of patient calls to clinic for adjustment in therapy, an improved percentage of LV pacing over 6 months compared to historical controls from the same clinic, as well as self-reported patient engagement. Timeliness of patient calls to clinic will be evaluated through record of patient calls to clinic 6 months prior to study and 6 months during study. Patient engagement will be evaluated through patient survey at start and end of study.

Patients will follow standard of care + intervention during study.

• Study Type: Interventional
• Enrollment (Anticipated): 10
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Indiana
    • Fort Wayne, Indiana, United States, 46845
      • Parkview Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

FOCUS GROUPS

Inclusion Criteria:

1. Remotely monitored with CRT-CIED

   • focus groups 1 & 2: implant ≤ 12 months
   • focus groups 3 & 4: implant ≥ 12 months
2. Current patient of PPG-Cardiology
3. History of HFrEF (heart failure in the setting of reduced ejection fraction)
4. Access to computer and internet
5. *Ability to provide informed consent

6. *Age ≥ 18 years

   • 5 and 6 must apply to caregivers, partners, and/or support persons

Exclusion Criteria:

1. Not remotely monitored with CRT-CIED
2. Not current patient of PPG-Cardiology
3. No history of HFrEF
4. Pacemaker dependent
5. Does not have access to computer and internet
6. *Inability to provide informed consent
7. *Age < 18 years

8. *Does not meet inclusion criteria

   • Only 6, 7, and 8 apply to caregivers, partners, and/or support persons

TECHNOLOGY TRIAL

Inclusion Criteria:

1. Remotely monitored with Biotronik CRT-CIED for more than 60 days
2. Ability to provide informed consent
3. Age ≥ 18 years
4. Willing to have MyChart or proxy to MyChart
5. Current patient of PPG-Cardiology
6. History of HFrEF

Exclusion Criteria:

1. Do not have a Biotronik CRT
2. Have a Biotronik CRT-CIED for less than 60 days
3. Not being remotely monitored with a Biotronik CRT-CIED
4. No history of HFrEF
5. Inability to provide informed consent
6. Age < 18 years
7. Lack of internet access or otherwise unable to access MyChart
8. Pacemaker dependency
9. Does not meet inclusion criteria

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Heart Failure Patients with CRT-CIED; PHR Messaging to notify patient of device transmitted information (i.e. percentage LV pacing)	Other: PHR Messaging; PHR messaging of data pertinent to chronic resynchronization therapy and heart failure management (i.e. percentage LV pacing).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Timeliness of calls to clinic for adjustment in therapy	6 months during study
Patient engagement evaluated through patient survey	6 months during study
Improved percentage of LV pacing	6 months during study

Collaborators and Investigators

• Sponsor: Parkview Health
• Collaborators: Biotronik, Inc.
• Investigators: Principal Investigator: Tammy Toscos, PhD, Parkview Health; Principal Investigator: Michael Mirro, MD, Parkview Health

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2016
• Primary Completion (Actual): August 1, 2019
• Study Completion (Actual): October 5, 2019

Study Registration Dates

• First Submitted: January 27, 2016
• First Submitted That Met QC Criteria: February 10, 2016
• First Posted (Estimate): February 15, 2016

Study Record Updates

• Last Update Posted (Actual): October 30, 2019
• Last Update Submitted That Met QC Criteria: October 28, 2019
• Last Verified: October 1, 2019

More Information

Terms related to this study

• Keywords: Cardiac Resynchronization Therapy; Cardiac Resynchronization Therapy Devices
• Additional Relevant MeSH Terms: Heart Diseases; Cardiovascular Diseases; Heart Failure
• Other Study ID Numbers: PRC15-0904 BTK

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: There is no plan to make individual participant data available.