- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06823583
Multi-Site Feasibility Testing of the Ventricular Assist Device Anticipatory Guidance Tool
There are a variety of educational documents available to help in a participant's decision for VAD implant, however there is little information available to potential participants to help understand areas of satisfaction and concern following a VAD implant as various time points. The investigators want to provide better patient care through increased education and awareness beyond surgical outcomes and contribute to patient understanding of "what to expect" following a VAD implant.
The investigators have created an anticipatory guidance (AG) tool based upon previous responses recorded in a local program's database, from the Quality of Life with a Left Ventricular Assist Device (QoLVAD) questionnaire. This questionnaire has five different domains (physical, social, emotional, cognitive thinking and spiritual/well-being). Investigators have previously analyzed responses to determine common areas of satisfaction and concern at 3-, 6-, 12- and 24-months post-VAD implant to better understand quality of life when living with a VAD. Investigators have had both VAD clinicians and VAD patients initially evaluate the tool to determine accuracy and effectiveness of the anticipatory guidance (AG) tool.
Study Overview
Status
Detailed Description
Advanced heart failure (HF) accounts for up to 10% of the overall HF population, and is demonstrated through increased hospitalizations, worsening shortness of breath and decrease in energy. A left ventricular assist device (VAD) and/or cardiac transplantation are promising surgical options to treat advanced HF beyond traditional guideline driven medical therapy, however not always designed for everyone. There are extensive educational materials available preoperatively designed to provide additional information to ease the decision-making process when receiving a VAD, yet most of this material is used to help decide on whether to get a VAD and has less to do with what to expect following a VAD. No information exists to date on describing expectations and outcomes at various time points following VAD. Anticipatory guidance (AG) models primarily exist in the pediatric populations to help parents and caregivers understand the "typical" milestones of what to expect. There are scarce AG models available for adults with chronic comorbid conditions, such as HF. An AG tool specific to VAD patients would be beneficial as preoperative education for potential VAD patients to help better understand the more commonly defined expectations of outcomes beyond adverse event risks, and in turn, hopefully decreases anxiety and depression post-VAD implant, improve domains of health-related quality of life (HRQoL), and decrease hospitalizations.
The Phase 1 study evaluated the development of a prototype AG tool from both longitudinal data analyzed from internal "Quality of Life with a Left Ventricular Assist Device" (QoLVAD) questionnaires that were previously completed as part of a local program's database, and from additional supporting literature. The prototype AG tool has undergone a two-part Delphi method evaluation by 10 international VAD clinicians, and necessary modifications were made based upon results from the two-part Delphi method. An additional round of Delphi method evaluation with local VAD patients was completed with final modifications to reflect the responses from the VAD patients to develop the "VAD AG Tool v5.0". The Phase 2 tool will be referred to as the "VAD AG tool v5.0".
For this phase 2 study, the purpose is to evaluate the VAD AG tool v5.0 across three VAD implanting centers in the United States, with the perspectives of both VAD patients and clinicians. This will be accomplished through four aims: 1. Evaluate clinician perspectives of the VAD AG Tool v5.0; 2. Preoperative distribution of the VAD AG tool v5.0 for consented participants across three VAD implanting centers, to read preoperatively, and evaluate at postoperative time points (3, 6 and 12-months); 3. Describe postoperative VAD patient perceptions of VAD AG tool v5.0 at three time points (3, 6, and 12-months); and 4. Evaluate relationships between HRQoL and the following: anxiety, depression, cognition, and hospital readmissions.
Study Type
Enrollment (Estimated)
Contacts and Locations
Study Contact
- Name: Kristin Sandau, PhD, RN
- Phone Number: 612-625-0186
- Email: KSandau@umn.edu
Study Contact Backup
- Name: Sarah E Schroeder, PhD, MSN, BSN, RN-Diploma
- Phone Number: 402-481-8450
- Email: sarah.schroeder@bryanheart.com
Study Locations
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Nebraska
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Lincoln, Nebraska, United States, 68506
- Recruiting
- Bryan Heart
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Contact:
- Sarah E Schroeder, PhD, MSN, BSN, RN
- Phone Number: 4024833333
- Email: sarah.schroeder@bryanheart.com
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Wisconsin
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Milwaukee, Wisconsin, United States, 53215
- Not yet recruiting
- Advocate Aurora Health
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Contact:
- Riley Rossbach, BSBME
- Phone Number: 4142227434
- Email: riley.rossbach@aah.org
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Principal Investigator:
- Riley Rossbach, BSBME
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Sampling Method
Study Population
Description
Inclusion Criteria:
(For patient inclusion):
- scheduled for a VAD implantation
- English-speaking as the VAD AG Tool v5.0 has not yet been translated beyond English age ≥19 years at the time of implant as most states in North America have an age of majority for consent signing.
(-VAD clinician for the clinician evaluation process)
Exclusion Criteria:
- Not scheduled for VAD surgery
- Non English speaking
- <19 yrs of age (Not a VAD Clinician for the clinician evaluation process)
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
|---|
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VAD Clinician Cohort
Up to four VAD Clinicians at each of the three participating sites (a maximum total of 12) will provide feedback and evaluation of the VAD AG Tool v5.0 following consenting.
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|
VAD Patient Cohort
Each of the three sites will enroll a minimum of 3 patients and no more than 5 potential VAD patients (total of 21 for the three sites) to provide evaluation and feedback of accuracy and feasibility of the VAD AG Tool v5.0, occurring at 3-, 6- and 12-months following VAD implant.
All patient participants following consenting, will receive the tool pre-surgery and provide evaluation and guidance post surgery, along with de-identifiable demographic and clinic data.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Clinician perspectives
Time Frame: First two weeks of study initiation.
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Evaluate clinician perspectives of the Ventricular Assist Device Anticipatory Guidance Tool (VAD AG Tool) v5.0 for accuracy, by completing an evaluation where each item will be scored 1-4, as follows: 1 Not Relevant, 2 Somewhat Relevant, 3 Quite Relevant, 4 Highly Relevant
|
First two weeks of study initiation.
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Distribution of the Ventricular Assist Device Anticipatory Guidance Tool (VAD AG Tool) v5.0
Time Frame: 12 months
|
Each site investigator will validate that the Ventricular Assist Device Anticipatory Guidance Tool (VAD AG Tool) v5.0 was preoperatively distributed.
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12 months
|
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Postoperative patient perceptions of Ventricular Assist Device Anticipatory Guidance Tool (VAD AG Tool) v5.0
Time Frame: 12 months
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Consented patients will provide prospectives of the Ventricular Assist Device Anticipatory Guidance Tool (VAD AG Tool) v5.0, through a patient evaluation form where all tool items will be scored on a 1-4 scale, where 1 is Not Important, 2 is Somewhat Important, 3 is Quite Important, 4 is Highly Important
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12 months
|
|
Complete post-operative Quality of Life with a Left Ventricular Assist Device (QoLVAD)
Time Frame: 12 months
|
All consented participants will complete the QoLVAD questionnaire at three time points (3-6-12 months)
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12 months
|
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Complete post-operative Generalized Anxiety Disorder 7-item scale at three different time points
Time Frame: 12 months
|
All consented participants will complete the GAD-7 assessment at three time points (3-6-12 months)
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12 months
|
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Complete post-operative Patient Health Questionnaire-9 tool at three different time points
Time Frame: 12 months
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All consented participants will complete the PHQ-9 assessment at three time points (3-6-12 months)
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12 months
|
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Complete post-operative Trailmaking B assessment at three different time points
Time Frame: 12 months
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All consented participants will complete the Trailmaking B assessment at three time points (3-6-12 months)
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12 months
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Chair: Mathue Baker, MD, Bryan Heart
Publications and helpful links
General Publications
- Billingham SA, Whitehead AL, Julious SA. An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database. BMC Med Res Methodol. 2013 Aug 20;13:104. doi: 10.1186/1471-2288-13-104.
- McIlvennan CK, Magid KH, Ambardekar AV, Thompson JS, Matlock DD, Allen LA. Clinical outcomes after continuous-flow left ventricular assist device: a systematic review. Circ Heart Fail. 2014 Nov;7(6):1003-13. doi: 10.1161/CIRCHEARTFAILURE.114.001391. Epub 2014 Oct 7.
- Waldenburger N, Steinecke M, Peters L, Junemann F, Bara C, Zimmermann T. Depression, anxiety, fear of progression, and emotional arousal in couples after left ventricular assist device implantation. ESC Heart Fail. 2020 Oct;7(5):3022-3028. doi: 10.1002/ehf2.12927. Epub 2020 Jul 28.
- Highs and Lows of Life with a Left Ventricular Assist Device: Multi-Dimensional Perspectives Schroeder, S.E. et al. The Journal of Heart and Lung Transplantation, Volume 43, Issue 4, S606
- Longitudinal Quality of Life Assessment Following Ventricular Assist Device Therapy: A Pilot Study Using the QOLVAD Questionnaire Schroeder, S.E. et al. The Journal of Heart and Lung Transplantation, Volume 39, Issue 4, S91
- Sandau KE, Lee CS, Faulkner KM, Pozehl B, Eckman P, Garberich R, Weaver CE, Joseph SM, Hall S, Carey SA, Chaudhry SP, Schroeder SE, Hoffman RO 3rd, Feldman D, Birati EY, Soni M, Marble JF, Jurgens CY, Hoglund B, Cowger JA. Health-Related Quality of Life in Patients With a Left Ventricular Assist Device (QOLVAD) Questionnaire: Initial Psychometrics of a New Instrument. J Cardiovasc Nurs. 2021 Mar-Apr 01;36(2):172-184. doi: 10.1097/JCN.0000000000000774.
- Birriel B, Alonso W, Kitko LA, Hupcey JE. Family caregiver-reported outcomes regarding decision-making for left ventricular assist device implantation. Heart Lung. 2019 Jul-Aug;48(4):308-312. doi: 10.1016/j.hrtlng.2019.03.002. Epub 2019 Apr 10.
- Kitko LA, Hupcey JE, Birriel B, Alonso W. Patients' decision making process and expectations of a left ventricular assist device pre and post implantation. Heart Lung. 2016 Mar-Apr;45(2):95-9. doi: 10.1016/j.hrtlng.2015.12.003. Epub 2015 Dec 29.
- Sandau KE, Hoglund BA, Weaver CE, Boisjolie C, Feldman D. A conceptual definition of quality of life with a left ventricular assist device: results from a qualitative study. Heart Lung. 2014 Jan-Feb;43(1):32-40. doi: 10.1016/j.hrtlng.2013.09.004. Epub 2013 Oct 2.
- Mehra MR, Goldstein DJ, Cleveland JC, Cowger JA, Hall S, Salerno CT, Naka Y, Horstmanshof D, Chuang J, Wang A, Uriel N. Five-Year Outcomes in Patients With Fully Magnetically Levitated vs Axial-Flow Left Ventricular Assist Devices in the MOMENTUM 3 Randomized Trial. JAMA. 2022 Sep 27;328(12):1233-1242. doi: 10.1001/jama.2022.16197.
- Bytyci I, Bajraktari G. Mortality in heart failure patients. Anatol J Cardiol. 2015 Jan;15(1):63-8. doi: 10.5152/akd.2014.5731. Epub 2014 Aug 19.
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
- MCS-VAD-003
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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