- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04164004
Patient-Reported Outcome Measurement in Heart Failure Clinic (PRO-HF)
November 2, 2023 updated by: Alexander Sandhu, Stanford University
Randomized Trial of Patient-Reported Outcome Measurement in Heart Failure Clinic
This is a randomized study evaluating the effect of routinely collecting a standardized questionnaire of heart failure health status during heart failure clinic visits.
Participants will be randomized to early or delayed implementation of a validated health-related quality of life survey (the Kansas City Cardiomyopathy Questionnaire).
Participants randomized to early implementation will be given this 12-question survey at each heart failure clinic visit at the beginning of the study; their heart failure clinician will have access to survey results but will continue to manage participants based on standard treatment practice.
Patients randomized to delayed implementation will start receiving the survey at each clinic visit one year later.
By comparing the health status and treatment rates between early and delayed implementation, this study will determine the impact of standardized health status assessment on patient outcomes and clinician decision-making.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
1248
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
-
-
California
-
Stanford, California, United States, 94305
- Stanford Hospital & Clinics
-
-
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
Description
Inclusion Criteria:
- Stanford Heart Failure clinic visit during enrollment period
Exclusion Criteria:
- Seen in amyloid clinic
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: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Routine Collection of Patient-Reported Health Status (KCCQ-12 Arm)
Patients in the KCCQ-12 arm will undergo KCCQ-12 assessment of patient-reported heart failure health status in the electronic health record at each heart failure clinic visit beginning at the start of the trial.
Assessment results will be available to clinicians in the electronic health record when making treatment decisions during each clinic visit.
|
Health status assessment will be completed using the well-validated Kansas City Cardiomyopathy Questionnaire-12 prior to or at the time of heart failure clinic visits.
Other Names:
|
Active Comparator: Usual Care
Patients in the usual care arm will not complete KCCQ-12 assessments in the electronic health record with clinic visits.
They will complete a KCCQ-12 assessment at baseline that will not be available to the treating clinician.
|
Health status assessment will be completed using the well-validated Kansas City Cardiomyopathy Questionnaire-12 prior to or at the time of heart failure clinic visits.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Kansas City Cardiomyopathy Questionnaire-12 Score
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
The first KCCQ-12 score collected one year after randomization will be compared between the KCCQ-12 and usual care arms.
KCCQ-12 scores will be collected in the usual care arm starting one year after randomization.
Scores will be adjusted for baseline KCCQ-12 in both arms.
This will be the primary effectiveness outcome.
KCCQ-12 has 4 domains (Physical Limitation Score, Symptom Frequency Score, Quality of Life Score, Social Limitation Score) and one Summary Score.
Scores are scaled 0-100, where 0 denotes the lowest reportable health status and 100 the highest.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Kansas City Cardiomyopathy Questionnaire-12 Response Rate
Time Frame: 1 year
|
Frequency of KCCQ-12 response at each clinic visit among patients in the KCCQ-12 arm.
This will be the primary implementation outcome.
The rate will be calculated as the average number of responses divided by the total number of requests to complete the survey.
|
1 year
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of Patients on Beta-blocker Therapy Among Patients with Reduced Ejection Fraction
Time Frame: Evaluated at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Beta-blocker therapy use among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
|
Evaluated at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Median Dose of Beta-Blocker Therapy Among Patients with Reduced Ejection Fraction
Time Frame: Evaluated at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Among those patients on beta-blocker therapy, the specific medication and dose will be collected.
|
Evaluated at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients on Renin-Angiotensin-Aldosterone System Inhibitors Among Patients with Reduced Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Use of any renin-angiotensin-aldosterone system inhibitors among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
These include angiotensin-converting enzyme inhibitor, angiotensin receptor blockers, or angiotensin receptor-neprilysin inhibitors.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Median Dose of Renin-Angiotensin-Aldosterone System Inhibitors Among Patients with Reduced Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Among those patients on renin-angiotensin-aldosterone system inhibitors with left ventricular ejection fraction ≤ 40%, the specific medication and dose will be collected.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients on Mineralocorticoid Receptor Antagonist Among Patients with Reduced Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Mineralocorticoid receptor antagonist use among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Median Dose of Mineralocorticoid Receptor Antagonist Among Patients with Reduced Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Among the sub-group of patients with left ventricular ejection fraction ≤ 40% on Mineralocorticoid Receptor Antagonist therapy, the specific medication and dose will be collected.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients on Mineralocorticoid Receptor Antagonist Among Patients with Preserved/Mid-Range Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Mineralocorticoid receptor antagonist use among the sub-group of patients with left ventricular ejection fraction > 40%.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Median Dose of Mineralocorticoid Receptor Antagonist Among Patients with Preserved/Mid-Range Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Among the sub-group of patients with left ventricular ejection fraction > 40% on Mineralocorticoid Receptor Antagonist therapy, the specific medication and dose will be collected.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients on Hydralazine/Nitrate Therapy Among African-American Patients with Reduced Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Hydralazine/nitrate use among the subgroup of African-American patients with left ventricular ejection fraction ≤ 40%.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Median Dose of Hydralazine/Nitrate Therapy Among African-American Patients with Reduced Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Among the subgroup of African-American patients with left ventricular ejection fraction ≤ 40% on hydralazine/nitrate therapy, the specific dose will be collected
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients on Sacubitril-Valsartan Therapy among the sub-group of patients with Reduced Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Sacubitril-valsartan use among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Median Dose of Sacubitril-Valsartan Therapy among the sub-group of patients with Reduced Ejection Fraction
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Among the sub-group of patients with left ventricular ejection fraction ≤ 40% on sacubitril-valsartan, the specific dose will be collected.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients on Sodium/glucose cotransporter-2 inhibitors Therapy among the sub-group of patients with preserved/mid-range ejection fraction.
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Sodium/glucose cotransporter-2 inhibitors use among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients on Sodium/glucose cotransporter-2 inhibitors therapy among the sub-group of patients with left ventricular ejection fraction > 40%.
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Sodium/glucose cotransporter-2 inhibitors use among the sub-group of patients with left ventricular ejection fraction > 40%.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients on Ivabradine Therapy Among Patients with Reduced Ejection Fraction with a Heart Rate above 70 Beats per Minute on Beta-Blocker Therapy
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Ivabradine use among patients with left ventricular ejection fraction ≤ 35% and a heart rate above 70 beats per minute in sinus rhythm.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Median Dose of Ivabradine Therapy Among Patients with Reduced Ejection Fraction with a Heart Rate above 70 Beats per Minute on Beta-Blocker Therapy
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Among patients with left ventricular ejection fraction ≤ 35% and a heart rate above 70 beats per minute in sinus rhythm on ivabradine, the medication dose will be collected.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization
|
Percentage of Patients with a Implantable Cardiac Defibrillator Among Patients with Reduced Ejection Fraction
Time Frame: Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Presence of an implantable cardiac defibrillator among the sub-group of patients with left ventricular ejection fraction ≤ 35%.
|
Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Percentage of Patients with a Cardiac Resynchronization Therapy Device Among Patients with Reduced Ejection
Time Frame: Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Presence of cardiac resynchronization therapy among the sub-group of patients with left ventricular ejection fraction ≤ 35% with electrocardiogram findings consistent with a left bundle branch block with QRS width >150ms.
|
Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Percentage of Patients Given Cardiac Rehabilitation Referral Among Patients with Reduced Ejection Fraction
Time Frame: Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Referral to cardiac rehabilitation among the subgroup of patients with left ventricular ejection fraction ≤ 35%.
|
Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Number of Medication Adjustments per Heart Failure Clinic Visit
Time Frame: Within one year post-randomization
|
The number of medication adjustments made at each heart failure clinic visit.
These will include dose changes, new medications, and discontinuation of prior medicines.
|
Within one year post-randomization
|
Average Daily Loop Diuretic Dose
Time Frame: Each clinic visit over one year follow-up and first heart failure clinic visit at least one year after randomization
|
The specific loop diuretic and dose will be collected.
Diuretic doses will be converted into a standard total daily dose of loop diuretic.
|
Each clinic visit over one year follow-up and first heart failure clinic visit at least one year after randomization
|
Count of Hospitalizations per Patient
Time Frame: Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Heart failure hospitalizations and non-heart failure hospitalizations in the Stanford healthcare system during the follow-up period.
|
Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Count of Emergency Department Visits per Patient
Time Frame: Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Stanford emergency department visits during the follow-up period.
|
Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Count of Heart Failure Clinic Visits per Patient
Time Frame: Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Stanford heart failure clinic visits during the followup period.
|
Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Count of Telephone Encounters per Patient
Time Frame: Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Stanford heart failure telephone encounters during the follow-up period.
|
Evaluated through trial completion (first heart failure clinic visit at least one year post-randomization or via telephone interview 15 months post-randomization)
|
Percentage of Patients who Undergo Formal Advanced Heart Failure Therapy Evaluation
Time Frame: Within one year post-randomization
|
Formal work-up for heart transplant or LVAD (left ventricular assist device) eligibility
|
Within one year post-randomization
|
Quality of Patient Clinic Experience
Time Frame: First clinic visit post-randomization within approximately 14 days
|
The results from a 10-question survey with ordinal responses regarding patient experience in clinic to a sub-study of all participants enrolled after the first month.
|
First clinic visit post-randomization within approximately 14 days
|
Correlation Between Clinician and Patient Perception of Health Status
Time Frame: First clinic visit post-randomization within approximately 14 days
|
Patient and clinician perception of health status will be collected.
Patient perception is collected via the KCCQ-12 while clinicians will be surveyed regarding health status.
We will determine the correlation between patient and clinician perception using an ordinal scale.
We will compare correlation across arms.
|
First clinic visit post-randomization within approximately 14 days
|
Cardiovascular Diagnostic Test Frequency
Time Frame: Within one year post-randomization
|
Number of diagnostic tests performed between randomization and one year post-randomization.
Diagnostic tests include cardiovascular imaging (echocardiography, MRI, cardiac CT, nuclear scan), invasive testing (coronary angiography, right heart catheterization), or ambulatory rhythm monitoring.
|
Within one year post-randomization
|
Kansas City Cardiomyopathy Questionnaire-12 Score Among Patients with Heart Failure or Cardiomyopathy
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview/web questionnaire 15 months post-randomization
|
The first KCCQ-12 score collected one year after randomization will be compared between the KCCQ-12 and usual care arms among patients with heart failure or cardiomyopathy The first KCCQ-12 score collected one year after randomization will be compared between the KCCQ-12 and usual care arms.
KCCQ-12 scores will be collected in the usual care arm starting one year after randomization.
Scores will be adjusted for baseline KCCQ-12 in both arms.
This will be the primary effectiveness outcome.
KCCQ-12 has 4 domains (Physical Limitation Score, Symptom Frequency Score, Quality of Life Score, Social Limitation Score) and one Summary Score.
Scores are scaled 0-100, where 0 denotes the lowest reportable health status and 100 the highest.
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview/web questionnaire 15 months post-randomization
|
Kansas City Cardiomyopathy Questionnaire-12 Score Among Patients with Sub-optimal health status at baseline
Time Frame: Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview/web questionnaire 15 months post-randomization
|
The first KCCQ-12 score collected one year after randomization will be compared between the KCCQ-12 and usual care arms among patients with baseline KCCQ <100 at baseline
|
Collected at the first heart failure clinic visit at least one year post-randomization or via telephone interview/web questionnaire 15 months post-randomization
|
Number of Total Heart Failure Medication Adjustments
Time Frame: Number of medication adjustments from randomization to one year post randomization
|
The total number of heart failure medication adjustments.
Heart failure medications include beta-blockers, renin-angiotensin-aldosterone system inhibitors, mineralocorticoid receptor antagonists, sodium/glucose cotransporter-2 inhibitors, hydralazine/nitrate therapy, ivabradine, or loop diuretics.
|
Number of medication adjustments from randomization to one year post randomization
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Alexander T Sandhu, MD, MS, Instructor of Medicine
- Principal Investigator: Paul A Heidenreich, MD, Professor of Medicine
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.
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)
August 30, 2021
Primary Completion (Estimated)
November 15, 2023
Study Completion (Estimated)
December 15, 2023
Study Registration Dates
First Submitted
November 12, 2019
First Submitted That Met QC Criteria
November 12, 2019
First Posted (Actual)
November 15, 2019
Study Record Updates
Last Update Posted (Actual)
November 7, 2023
Last Update Submitted That Met QC Criteria
November 2, 2023
Last Verified
October 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 53713
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Heart Failure
-
Tufts Medical CenterMetro West Medical CenterCompletedCongestive Heart Failure | Diastolic Heart Failure | Systolic Heart FailureUnited States
-
Abbott Medical DevicesCompletedHeart Failure | Heart Failure, Diastolic | Heart Failure, Systolic | Heart Failure NYHA Class II | Heart Failure NYHA Class III | Heart Failure With Reduced Ejection Fraction | Heart Failure NYHA Class IV | Heart Failure With Normal Ejection Fraction | Heart Failure; With Decompensation | Heart Failure...United States, Canada
-
Manipal UniversityUnknownHeart Failure | Decompensated Heart Failure | Acute Heart Failure | Diastolic Heart Failure | Systolic Heart FailureIndia
-
University Hospital, MontpellierCompletedHeart Failure | Diastolic Heart Failure | Systolic Heart Failure Stage CFrance
-
VA Eastern Colorado Health Care SystemNational Institute on Aging (NIA)CompletedHeart Failure | Heart Failure, Diastolic | Heart Failure, Systolic | Heart Failure With Reduced Ejection Fraction | Heart Failure With Preserved Ejection Fraction | Heart Failure; With Decompensation | Heart Failure,Congestive | Heart Failure AcuteUnited States
-
Lancaster General HospitalLouise von Hess Medical Research InstituteEnrolling by invitationDiastolic Heart FailureUnited States
-
Wake Forest UniversityCompletedHeart Failure, Congestive | Heart Failure With Preserved Ejection Fraction
-
Giresun UniversityIstanbul University - Cerrahpasa (IUC)RecruitingHeart Failure | Diastolic Heart Failure | Systolic Heart FailureTurkey
-
US Department of Veterans AffairsCompleted
-
Wake Forest UniversityNational Institute on Aging (NIA)CompletedHeart Failure, Congestive | Diastolic Heart FailureUnited States
Clinical Trials on Kansas City Cardiomyopathy Questionnaire-12
-
Chinese University of Hong KongEnrolling by invitation
-
Rennes University HospitalRecruitingTransthyretin Amyloidosis | Amyloidosis, HereditaryFrance
-
Pr. Nicolas GIRERDRecruiting
-
Central Hospital, Nancy, FranceRecruitingAcute Heart FailureFrance
-
Pr. Nicolas GIRERDRecruitingChronic Heart Failure | Reduced Ventricular Ejection FractionFrance
-
Central Hospital, Nancy, FranceRecruiting
-
Central Hospital, Nancy, FranceRecruitingAcute Heart FailureFrance
-
Central Hospital, Nancy, FranceRecruitingChronic Heart Failure | Preserved Ejection FractionFrance
-
Maria LendorfAarhus University Hospital; Danish Cancer Society; Hospital of Southern Jutland; Nordsjællands Hospital, DenmarkRecruitingBreast Cancer | CIPN - Chemotherapy-Induced Peripheral NeuropathyDenmark
-
Assistance Publique - Hôpitaux de ParisWithdrawnChronic Otitis MediaFrance