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.
調査の概要
詳細な説明
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.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
-
-
Minnesota
-
Rochester、Minnesota、アメリカ、55906
- Saint Marys Hospital
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
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.)
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：診断
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：トリプル
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
アクティブコンパレータ：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.
|
|
アクティブコンパレータ：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.
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
時間枠 |
|---|---|
|
Mean Percentage of Time in Therapeutic Range
時間枠：baseline to 3 months
|
baseline to 3 months
|
二次結果の測定
結果測定 |
時間枠 |
|---|---|
|
Mean Percentage of INR Tests Within the Therapeutic Range
時間枠：baseline to 3 months
|
baseline to 3 months
|
|
Mean Number of INR Tests Performed
時間枠：baseline to 3 months
|
baseline to 3 months
|
協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- 07-001398
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
Management of Anticoagulationの臨床試験
-
Hôpital Léon Bérard完了
-
Queens College, The City University of New York募集American Journal of Public Healthに投稿された論文の出版アメリカ
-
Swansea University完了A Bite of ACT' (BOA) Acceptance and Commitment Therapy オンライン心理教育コース | 待機リスト コントロールイギリス
-
Scripps Translational Science Institute完了
Usual Careの臨床試験
-
Massachusetts General HospitalNational Institutes of Health (NIH); Samaritans of Bostonまだ募集していません自殺念慮 | 自殺未遂 | 自殺
-
New York UniversitySt. Luke's-Roosevelt Hospital Center完了
-
New York UniversityIndiana University; Moi University完了
-
Fondation Oeuvre de la Croix Saint-Simon引きこもった
-
Boston Medical CenterNational Institute on Minority Health and Health Disparities (NIMHD); Center for Community Health...完了肥満 | 喘息 | 血圧 | 小児発達 | ヘルスケアの利用 | 児童虐待 | 医療格差 | 満たされていない基本的な社会的ニーズアメリカ
-
University Health Network, Toronto募集リンパ腫 | リンパ増殖性疾患 | 乳がんステージ I | 乳がんステージ II | 大腸がんステージ II | 結腸直腸がん III期 | 乳がんステージ III | 結腸直腸がんステージ I | 頭頸部がん III期 | 乳がん、ステージ0 | 頭頸部がんステージ I | 頭頸部がんステージ IIカナダ
-
Emory UniversityFoundation for Physical Therapy, Inc.完了
-
Saint-Joseph University完了