- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02901314
My Recordable On-Demand Audio Discharge Instructions (MyROAD)
August 11, 2022 updated by: Nancy M. Albert, Ph.D., The Cleveland Clinic
My Recordable On-Demand Audio Discharge Instructions (MyROAD)
Non-adherence to the heart failure (HF) plan of care after hospital discharge has been associated with clinical outcomes, including the combined endpoint of all-cause mortality and rehospitalization for decompensated HF.
Patients and informal caregivers receive education materials but may not act due to multiple factors.
A recorded message that could be repeatedly played by patients and caregivers might increase adherence to post-discharge self-care behaviors and early follow-up appointments, and have clinical benefits related to a reduction in all-cause mortality and rehospitalization.
The purposes of this randomized, controlled study are to examine the effects of use of a novel MyROAD (Recordable On-Demand Audio Discharge) card, given to patients at discharge.
The aims of this single-blind, placebo-controlled study are to examine the effects of recorded messages that can be replayed post discharge (delivered via the MyROAD card) on multiple subjective and objective clinical outcomes.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Non-adherence to the heart failure (HF) plan of care after hospital discharge has been associated with clinical outcomes, including the combined endpoint of all-cause mortality and rehospitalization for decompensated HF.
Most patients are discharged with a complex set of instructions that include multiple medications (and differing mediation administration plans), sodium restricted diet, fluid management actions (daily weight monitoring and in some cases, fluid restriction), monitoring signs and symptoms of HF, activity and exercise, and when to return for follow-up.
At discharge, patients (and their families) may not understand that HF is chronic.
Improvement in quality of life may be dependent on patients' acceptance of HF as a chronic, irreversible condition that requires self-care monitoring and behaviors (for example, becoming or staying physically active), even when they feel fine.
To decrease the complexity of understanding HF, patients receive a HF handbook and a "zones" 1-page handout before discharge.
In addition, they can watch multiple video clips of many HF topics and discuss HF self-care with the hospital healthcare team.
However, patients may not read (or view) education materials due to health literacy issues, cognitive decline, eyesight issues, fatigue or depression.
Patients may rely on lay (family) caregivers to understand self-car expectations and be active partners in care.
Caregivers engaged in patients' care may not be present at discharge or may have preconceived or inaccurate ideas about HF self-care after discharge.
A recorded message that could be repeatedly played by patients and caregivers might increase adherence to post-discharge self-care behaviors and 7-day follow-up appointments, and have clinical benefits related to a reduction in all-cause mortality and rehospitalization.
The purposes of this randomized, controlled study are to examine the effects of use of a novel MyROAD (Recordable On-Demand Audio Discharge) card, given to patients at discharge.
The aims of this single-blind, placebo-controlled study are to examine the effects of recorded messages that can be replayed post discharge (delivered via the MyROAD card) on (1) 45-, 90-, and 180-day first occurrence and (2) time to first occurrence of all-cause and HF-related hospitalization, ED visits and death/ cardiac transplantation/ventricular assist device, (3) 45-day quality of life (KCCQ), symptoms (investigator initiated tool; used in previous research), functional status (DASI) and perceived adherence to activity recommendations (investigator initiated tool; used in previous research), and (4) 7-day follow-up appointment with the healthcare provider assigned before discharge.
A total of 1066 patients (968 + 10% attrition) with decompensated HF will be randomized to either usual care or usual care and receiving a MyROAD card at discharge.
Study Type
Interventional
Enrollment (Actual)
1073
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
-
-
Ohio
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Cleveland, Ohio, United States, 44195
- Cleveland Clinic Main Campus
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Cleveland, Ohio, United States
- Cleveland Clinic Fairview Hospital
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Mayfield Heights, Ohio, United States, 44124
- Cleveland Clinic Hillcrest Hospital
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Medina, Ohio, United States
- Cleveland Clinic Medina Hospital
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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
18 years and older (ADULT, OLDER_ADULT)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Not referred for cardiac transplantation or ventricular assist device during the index hospitalization,
- Minimum age 18 years (no upper age limit),
- Ability to read and write,
- Discharge to home or to a family member's home and has control of making self-care decisions,
- Willing to participate; which requires three (3) follow-up telephone calls post-discharge.
Exclusion Criteria:
- Chart documented psychiatric or cognitive conditions that limit ability to understand or adhere to self-care recommendations (Alzheimer's condition, dementia, schizophrenia, other neurological history that impairs memory),
- Plans to discharge to assisted living apartment/center, skilled nursing facility or hospice care center,
- Receiving home hospice or palliative care; or has a medical condition reflecting less than 1 year of survival (cachexia, end stage liver disease or cancer or non-ambulatory New York Heart Association functional class IV heart failure),
- Post-cardiac transplantation or ventricular assist device placement,
- Currently enrolled in another experimental HF research study,
- Chronic renal failure and receiving chronic hemodialysis therapy for an estimated glomerular filtration rate < 30 mL/minute/1.73 m2,
- A non-traditional form of HF (hypertrophic or restrictive forms of cardiomyopathy, congenital heart disease or Takotsubo cardiomyopathy).
- Wheelchair bound, uses a cane or walker, or unable to carry out physical activity, including walking,due to a chronic disability or documented medical condition.
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: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: MyRoad
Receives usual care heart failure education before discharge AND a card at discharge that provided pre-recorded audio messages that can be played back on-demand on 4 themes: heart failure signs/symptoms assessment, medications, activity and exercise and diet and a general message about the importance of follow-up post discharge and following the plan of care.
|
|
No Intervention: Usual care
Receives usual care heart failure education before discharge
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
heart failure rehospitalization
Time Frame: 30 day
|
Chart review; interviews
|
30 day
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
time to first occurrence of HF-related hospitalization, ED visit or death/ cardiac transplantation/ventricular assist device(composite outcome)
Time Frame: time to first occurrence up to 30 days
|
chart review; interviews
|
time to first occurrence up to 30 days
|
functional status
Time Frame: 45 day
|
Duke Activity Status Index (telephone call)
|
45 day
|
perceived adherence to activity recommendations
Time Frame: 45 day
|
investigator developed tool; used in previous research (telephone call)
|
45 day
|
7-day follow-up appointment with the healthcare provider assigned before discharge
Time Frame: 45 day
|
chart review; interview (telephone call)
|
45 day
|
all cause re-hospitalization or ED visit or death or cardiac transplantation/ventricular assist device (composite outcome)
Time Frame: 180 days
|
chart review; interview (telephone call)
|
180 days
|
all cause re-hospitalization or ED visit or death or cardiac transplantation/ventricular assist device (composite outcome)
Time Frame: 30 days
|
chart review; interview (telephone call)
|
30 days
|
all cause re-hospitalization or ED visit or death or cardiac transplantation/ventricular assist device (composite outcome)
Time Frame: 90 day
|
chart review; interview (telephone call)
|
90 day
|
quality of life (health status)
Time Frame: 45 day
|
Kansas City Cardiomyopathy Questionnaire; telephone call
|
45 day
|
Symptoms of HF
Time Frame: 45 day
|
investigator developed tool; used in previous research; telephone call
|
45 day
|
time to first occurrence of all-cause hospitalization, ED visit or death/ cardiac transplantation/ventricular assist device (composite outcome)
Time Frame: time to first occurrence up to 180 days
|
chart review; interview (telephone call)
|
time to first occurrence up to 180 days
|
heart failure re-hospitalization
Time Frame: 180 day
|
chart review; interview (telephone call)
|
180 day
|
heart failure re-hospitalization
Time Frame: 90 day
|
chart review; interview (telephone call)
|
90 day
|
time to first occurrence of all-cause hospitalization, ED visit or death/ cardiac transplantation/ventricular assist device (composite outcome)
Time Frame: time to first occurrence up to 90 days
|
chart review; interview (telephone call)
|
time to first occurrence up to 90 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
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 (Actual)
March 1, 2016
Primary Completion (Actual)
September 30, 2020
Study Completion (Actual)
March 30, 2022
Study Registration Dates
First Submitted
September 1, 2016
First Submitted That Met QC Criteria
September 10, 2016
First Posted (Estimate)
September 15, 2016
Study Record Updates
Last Update Posted (Actual)
August 12, 2022
Last Update Submitted That Met QC Criteria
August 11, 2022
Last Verified
August 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 16-122
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
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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