- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05622929
Cluster Randomized Trial of a Digital Quality Improvement Intervention on LDLCholesterol Control (SAPPHIRE-LDL)
A Pragmatic Cluster Randomized Trial to Assess the Effect of a Digitally Enabled Quality Improvement Intervention on LDL Cholesterol Control in Atherosclerotic Established Cardiovascular Disease Patients
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Karla E Santo, PhD
- Phone Number: +55 11 2151-5915
- Email: karla.santo@einstein.br
Study Locations
-
-
BA
-
Salvador, BA, Brazil
- Recruiting
- Hospital da Bahia
-
Contact:
- Marianna Dracoulakis
-
Principal Investigator:
- Marianna Dracoulakis, MD
-
-
MG
-
Poços De Caldas, MG, Brazil
- Recruiting
- Hospital Santa Lúcia
-
Contact:
- Frederico Dall'Orto
-
Principal Investigator:
- Frederico Dall'Orto, MD
-
-
PR
-
Campina Grande Do Sul, PR, Brazil
- Recruiting
- Hospital e Maternidade Angelina Caron
-
Contact:
- Dalton Precoma
-
Principal Investigator:
- Dalton Precoma, MD
-
-
SC
-
Joinville, SC, Brazil
- Recruiting
- Hospital Regional Hans Dieter Schmidt
-
Contact:
- Conrado HOFFMANN FILHO
-
Principal Investigator:
- Conrado HOFFMANN FILHO, MD
-
-
SE
-
Aracaju, SE, Brazil
- Recruiting
- Centro de Pesquisa Clínica do Coração
-
Contact:
- Fabio Silveira
-
Principal Investigator:
- Fabio Silveira, MD
-
-
SP
-
Bragança Paulista, SP, Brazil
- Recruiting
- Hospital Universitário São Francisco de Assis
-
Contact:
- Murillo Antunes
-
Principal Investigator:
- Murillo Antunes, MD
-
Campinas, SP, Brazil
- Recruiting
- Instituto de Pesquisa Clínica de Campinas
-
Contact:
- Jose Francisco Saraiva
-
Principal Investigator:
- Jose Francisco Saraiva, MD
-
Marília, SP, Brazil
- Recruiting
- Irmandade da Santa Casa de Misericórdia de Marilia
-
Contact:
- Pedro Andrade
-
Principal Investigator:
- Pedro Andrade, MD
-
Matão, SP, Brazil
- Recruiting
- Hospital Carlos Fernando Malzoni
-
Principal Investigator:
- Cesar Minelli, MD
-
Contact:
- Cesar Minelli
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Patient Eligibility Criteria:
Inclusion Criteria:
- Capable of using a smartphone with iOS or Android System AND
Established ASCVD, including:
Coronary Artery Disease (CAD):
- Prior myocardial infarction
- Prior coronary revascularization - percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG)
- Angiographic or computerized tomography (CT)-imaging evidence of coronary atherosclerosis (≥ 50% stenosis in at least one major epicardial coronary artery)
Stroke:
• Prior ischemic stroke thought not to be caused by an embolic cause (e.g., atrial fibrillation, valvular heart disease or mural thrombus)
Peripheral Artery Disease (PAD):
- Prior documentation of a resting ankle-brachial index ≤ 0.9
- History of prior percutaneous or surgical revascularization of an iliac, femoral, or popliteal artery
- Prior non-traumatic amputation of a lower extremity due to peripheral artery disease
- History of prior percutaneous or surgical carotid artery revascularization
- Carotid Stenosis > 50% on prior angiography or ultrasound AND
- Provision of informed consent
Exclusion Criteria:
- Patients with a recent cardiovascular event, less than 3 months prior to study inclusion
- Patients with LDL-C ≤ 70 mg/dL
- Current participation in other clinical trials involving lipid lowering treatments
- Patients that do not consent to trial participation
Cluster Eligibility Criteria:
Inclusion Criteria:
- Outpatient Clinics from public or private hospitals OR, Private Practices, which assist patients with previous ASCVD on secondary prevention that provide a unit/institution authorization form for participation in the trial AND
- Minimum monthly volume of 20 ASCVD patients
Exclusion Criteria:
- Clusters that do not provide the unit/institution authorization form.
Study Plan
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: Intervention group
Real-world evidence (RWE) platform to provide data on their clinical practice + usual care + Digitally-enabled Multifaceted Quality Improvement Intervention
|
Digitally-enabled multifaceted strategy in addition to access to a RWE platform to provide clinical data. The digitally-enabled multifaceted strategy will include various tools that will provide support to the health professionals responsible for treating ASCVD patients in each center as well as patients, including:
|
Active Comparator: Control group
RWE platform to provide data on their clinical practice + usual care
|
Health professionals responsible for treating ASCVD patients in each center will continue to provide usual care to ASCVD patients in addition to provide data through a RWE platform.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Phase 1: LDL-C levels
Time Frame: Baseline
|
LDL-C levels measured at a single visit
|
Baseline
|
Phase 2: LDL-C
Time Frame: 12 months
|
LDL-C levels measured at the end of follow up of Phase 2
|
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Phase 1: Prescribed lipid-lowering therapy
Time Frame: Baseline
|
Percentage of patients on prescribed lipid-lowering therapy
|
Baseline
|
Phase 1: Prescribed combination lipid-lowering therapy
Time Frame: Baseline
|
Percentage of patients on prescribed combination lipid-lowering therapy
|
Baseline
|
Phase 1: Prescribed intensive lipid-lowering therapy
Time Frame: Baseline
|
Percentage of patients on prescribed intensive lipid-lowering therapy
|
Baseline
|
Phase 1: Prescription of high intensity statins
Time Frame: Baseline
|
Percentage of prescription of high intensity statins
|
Baseline
|
Phase 1: Prescription of ezetimibe
Time Frame: Baseline
|
Percentage of prescription of ezetimibe
|
Baseline
|
Phase 1: Prescription of PCSK9 inhibitors
Time Frame: Baseline
|
Percentage of prescription of PCSK9 inhibitors
|
Baseline
|
Phase 1: LDL-C < 50 mg/dL
Time Frame: Baseline
|
Percentage of patients with LDL-C < 50 mg/dL
|
Baseline
|
Phase 2: Prescribed lipid-lowering therapy
Time Frame: 12 months
|
Percentage of patients on prescribed lipid-lowering therapy
|
12 months
|
Phase 2: Prescribed combination lipid-lowering therapy
Time Frame: 12 months
|
Percentage of patients on prescribed combination lipid-lowering therapy
|
12 months
|
Phase 2: Prescribed intensive lipid-lowering therapy
Time Frame: 12 months
|
Percentage of patients on prescribed intensive lipid-lowering therapy
|
12 months
|
Phase 2: Prescription of high intensity statins
Time Frame: 12 months
|
Percentage of prescription of high intensity statins
|
12 months
|
Phase 2: Prescription of moderate intensity statins
Time Frame: 12 months
|
Percentage of prescription of moderate intensity statins
|
12 months
|
Phase 2: Prescription of low intensity statins
Time Frame: 12 months
|
Percentage of prescription of low intensity statins
|
12 months
|
Phase 2: Prescription of ezetimibe
Time Frame: 12 months
|
Percentage of prescription of ezetimibe
|
12 months
|
Phase 2: Prescription of PCSK9 inhibitors
Time Frame: 12 months
|
Percentage of prescription of PCSK9 inhibitors
|
12 months
|
Phase 2: LDL-C < 50 mg/dL
Time Frame: 12 months
|
Percentage of patients with LDL-C < 50 mg/dL
|
12 months
|
Phase 2: LDL-C relative change
Time Frame: 12 months
|
Change in LDL-C relative to baseline
|
12 months
|
Phase 2: LDL-C reduction of ≥50%
Time Frame: 12 months
|
Percentage of patients with LDL-C reduction of ≥50% relative to baseline
|
12 months
|
Phase 2: Barriers for drug prescription
Time Frame: 12 months
|
Barriers for drug prescription at the system (cluster) and physician level
|
12 months
|
Phase 2: Adherence to prescribed lipid-lowering therapy
Time Frame: 12 months
|
Patient´s adherence to prescribed lipid-lowering therapy
|
12 months
|
Phase 2: Barriers for drug adherence
Time Frame: 12 months
|
Patient´s barriers for drug adherence
|
12 months
|
Phase 2: Intolerance to Statins
Time Frame: 12 months
|
Percentage of patients with intolerance to Statins
|
12 months
|
Phase 2: 5P-MACE (Major Cardiovascular Events)
Time Frame: 12 months
|
Composite endpoint of time to first occurrence of a major cardiovascular event 5P-MACE including cardiovascular deaths.
non-fatal stroke or transient ischemic attack (TIA), non-fatal myocardial infarction, hospitalization for unstable angina, or coronary revascularization, whichever occurs first
|
12 months
|
Phase 2: 3P-MACE (Major Cardiovascular Events)
Time Frame: 12 months
|
Composite endpoint of time to first occurrence of a major cardiovascular event 3P-MACE including cardiovascular deaths, non-fatal stroke or TIA, or non-fatal myocardial infarction, whichever occurs first
|
12 months
|
Phase 2: Cardiovascular death
Time Frame: 12 months
|
Time to cardiovascular death
|
12 months
|
Phase 2: Death from any cause
Time Frame: 12 months
|
Time to death from any cause
|
12 months
|
Phase 2: Myocardial infarction
Time Frame: 12 months
|
Time to first myocardial infarction
|
12 months
|
Phase 2: Stroke
Time Frame: 12 months
|
Time to first stroke
|
12 months
|
Phase 2: Coronary revascularization
Time Frame: 12 months
|
Time to first coronary revascularization
|
12 months
|
Phase 2: Total deaths
Time Frame: 12 months
|
Total deaths within 12 months from inclusion
|
12 months
|
Collaborators and Investigators
Investigators
- Principal Investigator: M. Julia Machline-Carrion, PhD, epHealth
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CKJX839A1BR05R
- 63520022.6.1001.0071 (Other Identifier: CAAE)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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