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Social-software iMproving wARfarin Therapy (SMART)

17. juni 2019 opdateret af: Litao Zhang, MD, Wuhan Asia Heart Hospital

Randomized Evaluation of Social-software Improving Warfarin Therapy in Patients With Mechanical Heart Valve Replacement

Poor anticoagulation quality is a major problem among Chinese patients receiving warfarin therapy in traditional health care settings. Improving warfarin therapy has been crucial for Chinese patients. Wechat is social-software in China. Most of all Chinese adults use Wechat, as well as our patients. So we set up a Wechat-based mini-program to instruct Chinese patients' warfarin therapy. We aim to assess whether social software could improve warfarin therapy in Chinese patients by conducting a single-centre, open-label, prospective, randomized clinical trial.

Studieoversigt

Detaljeret beskrivelse

Social software is becoming a necessary of life. Wechat, powered by Tencent company, is the most popular social software in China. People can chat with others no matter how far away from each other.

Anticoagulation Quality is very important for patients receiving warfarin anticoagulation therapy, which is usually evaluated Time in therapeutic range (TTR). It is reported that TTR is very low (38.8%) in China patients. So we are planning to introduce the social software to set up a bridge for clinicians and their patients, to instruct warfarin therapy. We aim to investigate whether social software could be used to improve warfarin anticoagulation quality of Chinese patients.

We planned to enrol enough eligible patients receiving warfarin therapy due to the mechanical valves in a randomized controlled trial. Warfarin-treated patients were assigned to social software management group ( in which warfarin therapy was guided via the social platform by experienced clinicians) or to the traditional management control group (in which warfarin therapy was managed with traditional model). The primary outcomes the first time to bleeding or thrombotic events, the secondary outcomes were an elevation in time in therapeutic range (TTR) of international normalized ratio (INR), reduction in INR variation and number of extremely high INR results during 18 months.

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

735

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Hubei
      • Wuhan, Hubei, Kina, 430000
        • WAHH

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Received mechanical valve replacement;
  • Receiving warfarin anticoagulation therapy;
  • Have smartphone and Know how to use wechat application and our mini-program;
  • be expected to survive for the duration of the study;
  • not be suffering from intracranial bleeding (intracranial haemorrhage, subarachnoid haemorrhage, hemorrhagic stroke) or any other contraindication described in the warfarin package insert;
  • be willing to be randomized;
  • sign the informed consent form;
  • not be enrolled in another randomized clinical trial that involves a drug or device intervention.

Exclusion Criteria:

  • subject has had an intracranial haemorrhage, subarachnoid haemorrhage, hemorrhagic stroke, or any other absolute/major contraindication described in the warfarin package insert within the last month
  • subject enrolled in another randomized clinical trial that involves a drug or device intervention
  • subject is not able to follow the protocol and all related instructions and does not have a caregiver with these skills
  • Patients were considered being not suitable for this study

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Social-software management group
We set up a mini-program based on wechat application. We instruct warfarin therapy via social-software including dose adjustment, answer questions, remind monitoring INR et.al.
Using Wechat application, a social platform, to manage warfarin therapy in patients with mechanical valve replacement.
Ingen indgriben: Routine management group
This is the control group, Warfarin therapy was managed via traditional style without social software intervention.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time to First Event
Tidsramme: Up to 18 months
Thrombotic events, such as Valve thrombosis, Stroke, Peripheral embolism; Major bleeding, such as cerebral hemorrhage,gastrointestinal bleeding etc.
Up to 18 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time in therapeutic range
Tidsramme: Up to 18 months
Time in target range (TTR) based on Prothrombin Time standardized to the International Normalized Ratio
Up to 18 months
Individual variation of International Normalized Ratio (INR)
Tidsramme: Up to 18 months
Standard deviation (SD) of individual INR results
Up to 18 months
Times of extremely high International Normalized Ratio (INR) values
Tidsramme: Up to 18 months
Times of INR results above 4.0; Times of INR results above 12.0
Up to 18 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Efterforskere

  • Studieleder: Zhenlu ZHANG, MD,PhD, Wuhan Asia Heart Hospital

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. september 2017

Primær færdiggørelse (Faktiske)

1. marts 2019

Studieafslutning (Faktiske)

8. marts 2019

Datoer for studieregistrering

Først indsendt

22. august 2017

Først indsendt, der opfyldte QC-kriterier

28. august 2017

Først opslået (Faktiske)

29. august 2017

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

19. juni 2019

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

17. juni 2019

Sidst verificeret

1. juni 2019

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 2017-P-033

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

We are going to make individual participant data (IPD) available to other researchers after our paper published

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP
  • ICF
  • CSR

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Ingen

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Kliniske forsøg med Patient Compliance

Kliniske forsøg med Social-software management

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