- ICH GCP
- Registro de ensayos clínicos de EE. UU.
- Ensayo clínico NCT00703963
Improved Time in Therapeutic Range With Patient Self-Testing of Their INR Compared to Usual Care
Improved Time in Therapeutic Range With Patient Self-Testing of Their INR Compared to Usual Care: A Randomized Controlled Trial
Patients who receive a mechanical heart valve to replace a diseased heart valve must take an anticoagulation medicine the rest of their lives, and monitor their level of anticoagulation. Until recently, the testing of the level of anticoagulation was performed at medical laboratories or hospitals.
The purpose of this study is to see if patients who test their level of anticoagulation by themselves at home and then call their doctor with the result have better control of their anticoagulation as compared to patients whose anticoagulation is checked only by their physician.
Descripción general del estudio
Estado
Condiciones
Intervención / Tratamiento
Descripción detallada
Prosthetic replacement of diseased heart valves is a routine procedure, and mechanical heart valves have excellent hemodynamic performance and durability. However, mechanical valves are thrombogenic, necessitating lifelong anticoagulation. Hazards of anticoagulation include bleeding when it is excessive or thromboembolism when the intensity of anticoagulation is below the recommended level. Monitoring the level of anticoagulation is accomplished by analyzing the International Normalized Ratio. Until recently, this was performed at medical laboratories or hospitals, but recent literature suggests that patient self-testing of oral anticoagulation improves patient compliance, medical outcomes, and quality of life.
The objective of this study is to evaluate the time in therapeutic range of patients who self-test their INR compared to patients receiving the usual care. Additionally, we will evaluate the educational components and corollaries of self-testing.
Two hundred consecutively enrolled adults, having undergone implantation of a mechanical heart valve, will be randomized to either self-testing or usual care. Those randomized to the self-testing group will undergo self-testing instruction prior to hospital dismissal. For three months after hospital discharge, subject will record their INR results obtained by self-testing or as prescribed by their primary physician. They will then submit the record of the INR results and complete a survey.
Tipo de estudio
Inscripción (Actual)
Fase
- No aplica
Contactos y Ubicaciones
Ubicaciones de estudio
-
-
Minnesota
-
Rochester, Minnesota, Estados Unidos, 55906
- Saint Marys Hospital
-
-
Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Patients that received a mechanical valve while in our hospital
- Age > 18 years
Exclusion Criteria:
- Pregnant or lactating women
- Patients that have genetic clotting disorders such as Factor 5
- Physical disabilities (for example, poor eyesight, tremor, or other neurological disability) that would prevent the patient from being able to perform finger stick blood sampling. (Patients may not be excluded for physical disabilities if a care giver is willing to learn and assist with performing patient self-testing.)
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Diagnóstico
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Triple
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
---|---|
Comparador activo: Usual Care
Subjects will be having their INR tested by their Primary Care Provider as often as their Care Provider dictates.
This study phase is twelve weeks long beginning at the day of discharge from our hospital.
|
Usual care is defined as that care currently received by patients into whom mechanical heart valves are placed.
Typically, these patients undergo frequent checks of their INR level until the therapeutic range is achieved.
Then periodic INR levels are drawn at the discretion of the managing physician.
|
Comparador activo: Patient Self Testing
Subjects will be testing their INR at home using an FDA approved device (INRatio monitor by Hemosense) reporting their results to Quality Assured Services (QAS) via an 800 phone number; their Primary Care Provider will receive a fax with the INR result.
We ask this group of patients to test at minimum one time a week, additional testing as requested by their Primary Care Provider.
This phase lasts twelve weeks, beginning on the day of discharge from our hospital.
|
Home testing monitor to test patients INR by placing a capillary drop of blood from the finger onto a test strip.
The test strip is then inserted into the INRatio point-of-care self-testing coagulometer.
After approximately 2 minutes of analysis, the INR value will be presented on the meter's display.
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Periodo de tiempo |
---|---|
Mean Percentage of Time in Therapeutic Range
Periodo de tiempo: baseline to 3 months
|
baseline to 3 months
|
Medidas de resultado secundarias
Medida de resultado |
Periodo de tiempo |
---|---|
Mean Percentage of INR Tests Within the Therapeutic Range
Periodo de tiempo: baseline to 3 months
|
baseline to 3 months
|
Mean Number of INR Tests Performed
Periodo de tiempo: baseline to 3 months
|
baseline to 3 months
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Hartzell V Schaff, M.D. CS, Mayo Clinic
Publicaciones y enlaces útiles
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Otros números de identificación del estudio
- 07-001398
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .
Ensayos clínicos sobre Management of Anticoagulation
-
Queens College, The City University of New YorkReclutamientoPublicación de artículos enviados al American Journal of Public HealthEstados Unidos
-
Children's Healthcare of AtlantaTerminadoNiños que se sometieron a un trasplante de corazón antes de los 18 años | Atención recibida en Children's Healthcare of AtlantaEstados Unidos
Ensayos clínicos sobre Usual Care
-
Aarogyam UKNMP Medical Research Institute; Croydon Ayurveda Centre; Active Naturals Limited; AVP Research FoundationActivo, no reclutandoDesorden psiquiátricoIndia
-
University of Texas at AustinDesconocidoEsclerosis múltipleEstados Unidos
-
NYU Langone HealthNational Institute on Aging (NIA)Activo, no reclutandoDemenciaEstados Unidos
-
Icahn School of Medicine at Mount SinaiUniversity of WashingtonReclutamientoCáncer colonrectal | Cáncer de vejigaEstados Unidos
-
Assistance Publique Hopitaux De MarseilleReclutamiento
-
The University of Texas Health Science Center,...Aún no reclutandoNutrición en el embarazo de alto riesgoEstados Unidos
-
Silke Wiegand-Grefe, Prof. Dr.Charite University, Berlin, Germany; Hannover Medical School; University Hospital... y otros colaboradoresActivo, no reclutandoEnfermedades rarasAlemania
-
Elizabeth Glaser Pediatric AIDS FoundationUnited States Agency for International Development (USAID); Ministry of Health...TerminadoInfecciones por VIHSuazilandia
-
University Health Network, TorontoReclutamientoLinfoma | Trastornos linfoproliferativos | Etapa I del cáncer de mama | Cáncer de mama en estadio II | Cáncer colorrectal en estadio II | Cáncer colorrectal en estadio III | Etapa III del cáncer de mama | Cáncer colorrectal Etapa I | Cáncer de cabeza y cuello estadio III | Cáncer de mama, estadio 0 | Cáncer... y otras condicionesCanadá
-
KintoAlzheimer's AssociationTerminadoDemencia | Enfermedad de Alzheimer | Enfermedad de cuerpos de Lewy | Demencia frontotemporal | Demencia vascular | Demencia mixtaEstados Unidos