- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05447598
Remote Monitoring After Heart Failure
April 25, 2023 updated by: Vestre Viken Hospital Trust
Individually Tailored Remote Monitoring at Home After Hospitalisation for HEART Failure in Multi-morbid Patients (IT-HEART): a Randomised Clinical Trial
Heart failure (HF) is a leading cause of hospitalisation and disability-adjusted life years lost, with mortality rates exceeding most cancers.
Despite compelling evidence and recommendations, less than 20% of the HF patients are followed-up by the specialist healthcare after hospital discharge.
Due to limited outpatient capacity, human resources and increasing incidence of HF over the next decades, new care models are obviously needed.
Remote monitoring (i.e.
telemonitoring) encompasses the use of audio, video and other telecommunication technologies to monitor patient status at a distance.
Remote monitoring is a promising strategy that can facilitate rapid access to care when needed and reduce patient travel to hospital consultations.
It also promotes self-care behaviour, psychosocial support, and early detection of cardiac decompensation.
Despite intensive research for >10 years, randomised trials show conflicting results, and European HF guidelines are confined to a weak (class IIb, level of evidence B) recommendation.
More knowledge about the role of remote monitoring strategies in HF management, especially in the transition from hospital to home, is thus requested in the most recent European and US guidelines.
In particular, studies of high-risk patients integrating the community health services are largely lacking.
Furthermore, the components of the intervention that mediate the effect need to be identified.
The proposed study aims to address these gaps in evidence and assess whether individually tailored remote monitoring at home (IT-HEART) is improves clinical outcomes in patients hospitalized with decompensated HF.
We also aim to identify modifiable clinical and behavioural (drug adherence, self-care, psychological factors) outcome predictors.
A prospective, multicentre, randomized, open-label, blinded endpoint adjudication (PROBE) intervention study is designed and powered to include about 368 patients with at least one HF hospitalization in the 12 months preceding enrolment.
To ensure generalizability, patients will be included regardless of comorbidity, frailty and ejection fraction.
We have conducted a pilot-study providing empirical evidence for the expected participation rate, readmission rate and barriers to HF management in current clinical practice that will be targets for the intervention.
This will promote high adherence to the intervention and positive long-term clinical and health economic effects.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Anticipated)
368
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 Contact
- Name: John Munkhaugen, MD,PhD
- Phone Number: +47 97524194
- Email: johmun@vestreviken.no
Study Contact Backup
- Name: Elise Sverre, MD, PhD
- Email: elisbj@vestreviken.no
Study Locations
-
-
Vestfold And Telemark County
-
Tønsberg, Vestfold And Telemark County, Norway, 3103
- Recruiting
- Vestfold Hospital trust
-
Contact:
- Erlend Aune, MD, PhD
- Email: Erlend.aune@siv.no
-
Contact:
- Vidar Ruddox, MD, PhD
- Email: vidar.ruddox@siv.no
-
-
Viken County
-
Drammen, Viken County, Norway, 3004
- Recruiting
- Vestre Viken Trust Drammen hospital
-
Contact:
- Elise Sverre, MD, PhD
- Email: elisbj@vestreviken.no
-
Contact:
- John Munkhaugen, MD, PhD
- Phone Number: +4797524194
- Email: johmun@vestreviken.no
-
-
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:
- Age> 18 years
- Known HF diagnosis (ICD-10: I50) recorded in hospital medical records
- Admitted to hospital within 7 days before screening for acute HF with symptoms of decompensation including dyspnoea in NYHA class ≥ II, pulmonary congestion on chest x-ray and/or other signs like oedema or positive rales on auscultation and elevated NT-proBNP concentrations at screening
- Sign informed consent and expected to participate according to ICH / GCP
Exclusion Criteria:
- Any condition (e.g. psychosis, alcohol abuse, dementia) or situation that may pose a significant risk to the participant, confuse the results or make participation unethical
- Not able to understand Norwegian language
- Short life expectancy (<6 months) due to non-cardiac causes
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: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intervention
Remote monitoring program
|
Symptoms of disease progression, clinical parameters, medication adherence and follow-up needs will be reported by patients or with support from relatives or homecare nurses 2-4 times/months over a three months period using a digital platform.
Telephone monitoring is planned for patients who are not able to comply with the digital platform.
In addition, an individualized self-treatment plan for diuretics and lifestyle advice will be prepared, preferably together with relatives at the outpatient clinic.
Participants will also have access to a website with written information and videos about HF and self-management.
Finally, a pillbox will be delivered to facilitate drug adherence.
|
Active Comparator: Usual care
Current clinical pratice at the participating hospitals
|
Usual care treatment and follow-up care at the outpatient clinic and in primary care
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of re-hospitalizations for heart failure and total death
Time Frame: From time of randomization until 12 months follow-up
|
Rate of re-hospitalizations for heart failure and total death at 12 months follow-up assessed from hospital medical records between the treatment arms
|
From time of randomization until 12 months follow-up
|
Time to first re-hospitalization for heart failure and total death
Time Frame: From time of randomization until 12 months follow-up
|
Time to first re-hospitalization for heart failure and total death at 12 months follow-up assessed from hospital medical records between the treatment arms
|
From time of randomization until 12 months follow-up
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Rate of total death
Time Frame: From time of randomization until 12 months follow-up
|
Rate of total death at 12 months follow-up assessed from hospital medical records between the treatment arms
|
From time of randomization until 12 months follow-up
|
Rate of re-hospitalizations for heart failure
Time Frame: From time of randomization until 12 months follow-up
|
Rate of re-hospitalizations for heart failure at 12 months follow-up assessed from hospital medical records between the treatment arms
|
From time of randomization until 12 months follow-up
|
Total number of days lost due to unplanned cardiovascular hospital admissions treatment arms
Time Frame: From time of randomization until 12 months follow-up
|
Percentage of days lost due to unplanned cardiovascular hospital admissions at 12 months follow-up between the treatment arms assessed from hospital medical records
|
From time of randomization until 12 months follow-up
|
Changes in selfcare behaviour
Time Frame: From baseline until three months follow-up
|
Changes in selfcare behaviour measured by the revised 9-item European Heart Failure Selfcare behaviour Scale assessed by patient self-report on a five-point scale from "totally agree" to "totally disagree".
|
From baseline until three months follow-up
|
Collaborators and Investigators
This is where you will find people and organizations involved with this 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)
April 25, 2023
Primary Completion (Anticipated)
September 30, 2025
Study Completion (Anticipated)
December 30, 2026
Study Registration Dates
First Submitted
May 27, 2022
First Submitted That Met QC Criteria
July 5, 2022
First Posted (Actual)
July 7, 2022
Study Record Updates
Last Update Posted (Actual)
April 26, 2023
Last Update Submitted That Met QC Criteria
April 25, 2023
Last Verified
April 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 464460
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.
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