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Evaluation of a French Hospital Discharge Therapeutic Education Program by Nurses for Heart Failure Patient (EduSor) (EDUSOR)

2026년 11월 3일 업데이트: University Hospital, Clermont-Ferrand

Evaluation of a Therapeutic Patient Education Program for Discharge (ETPsh) by Nurses in a French Hospital Setting Among Patients With Heart Failure

Heart failure affects 2.3% of the adult French population. Readmission within 30 days doubles the risk of early death within the following 30 to 60 days, as well as the risk of rehospitalization over the subsequent two years. Incorporating nurse-led discharge education can significantly reduce readmissions for heart failure as well as all-cause readmissions. Drawing on practices from English-speaking countries and Switzerland regarding patient discharge education at hospital, we propose to evaluate a discharge education program in the French hospital setting for patients with heart failure.

The objective of this multicenter before-and-after study is to evaluate the impact of a nurse-led discharge education delivered at hospital on the quality of the care pathway for patients with heart failure, assessed 30 days after hospital discharge. The primary outcome is the reduction in 30-day unplanned all-cause hospital readmissions, including emergency department visits. An informal (non-professional) caregiver may also be enrolled in the study if identified by the patient and present during the hospitalization.

Patients enrolled before implementation of the discharge education will constitute the control group (standard therapeutic patient education group). They will receive usual hospital care, including educational sessions throughout hospitalization covering the disease, treatments, and self-care, as well as a follow-up consultation with a nurse 30 days after hospital discharge. This usual care is referred to as standard therapeutic patient education and does not include a structured therapeutic patient education intervention at hospital discharge.

Patients receiving the discharge education will constitute the intervention group (standard therapeutic patient education with discharge education group). They will receive the same usual care (i.e., standard therapeutic patient education and the 30-day post-discharge nurse follow-up consultation), supplemented by the nurse-led discharge education intervention during their hospitalization.

To minimize the risk of contamination (diffusion bias), the control group will be enrolled and complete follow-up before nurses receive training in the discharge education intervention.

연구 개요

상태

모병

정황

개입 / 치료

상세 설명

Patients and their informal caregivers will be informed about the study by the nursing staff within the first two days of hospitalization in the cardiology departments participating in the study. Their eligibility will then be assessed, and eligible patients and caregivers will be invited to participate. A participant information sheet describing the study will be provided and explained to both the patient and the informal caregiver.

Patients and their informal caregivers will be given a 24-hour reflection period. After this period, they will have the opportunity to discuss any remaining questions with the investigator nurse, who will provide any necessary clarification. Patients and informal caregivers who agree to participate will then sign the informed consent form and be enrolled in the study. The investigator will also sign the informed consent form.

All participants in the control group will be enrolled simultaneously across the three participating study centers. The same enrollment procedure will be followed for the intervention group.

Patients in the intervention group will receive an initial educational assessment on the day following enrollment, a participatory therapeutic education session using the teach-back method within the 24 hours preceding hospital discharge, a follow-up telephone call from a nurse 7 days after discharge, and a final educational assessment at the routine 30-day post-discharge follow-up visit. Whenever possible, the patient's informal caregiver will be asked to accompany the patient to this follow-up consultation.

A participant may be prematurely withdrawn from the study for any of the following reasons:

  • an intercurrent disease interfering with the normal conduct of the study protocol;
  • death;
  • participant's decision
  • a major protocol deviation;
  • loss to follow-up (a participant is considered lost to follow-up if they fail to attend a scheduled study visit and no information regarding their status can be obtained despite all reasonable efforts to contact them and determine the reason for study discontinuation. The reason "lost to follow-up" will only be assigned after these efforts have been unsuccessful).

Patients and their informal caregivers may participate in another clinical study provided that, in the opinion of the investigator, such participation does not interfere with the conduct or objectives of the present study. Participants must therefore inform the investigator of any concurrent participation in another study, and the investigator will determine whether simultaneous participation is appropriate.

The study may be temporarily suspended or permanently terminated for any of the following reasons:

  • insufficient or no participant recruitment;
  • inability to secure funding for the study;
  • any directive issued by the competent regulatory authorities requiring the temporary suspension or permanent termination of the study;
  • a decision by the sponsor and the coordinating investigator.

연구 유형

중재적

등록 (추정된)

412

단계

  • 해당 없음

연락처 및 위치

이 섹션에서는 연구를 수행하는 사람들의 연락처 정보와 이 연구가 수행되는 장소에 대한 정보를 제공합니다.

연구 연락처

연구 장소

      • Clermont-Ferrand, 프랑스
        • 모병
        • CHU Clermont-Ferrand
        • 연락하다:
        • 수석 연구원:
          • Sarah LAROCHE
      • Poitiers, 프랑스
        • 아직 모집하지 않음
        • CHU Poitiers
        • 연락하다:
        • 수석 연구원:
          • Alexandra MARTIN
      • Vichy, 프랑스
        • 아직 모집하지 않음
        • CH Vichy
        • 연락하다:
        • 수석 연구원:
          • Claude LAGRANGE

참여기준

연구원은 적격성 기준이라는 특정 설명에 맞는 사람을 찾습니다. 이러한 기준의 몇 가지 예는 개인의 일반적인 건강 상태 또는 이전 치료입니다.

자격 기준

공부할 수 있는 나이

18년 이상 (성인, 고령자)

건강한 자원 봉사자를 받아들입니다

아니

연구 대상 성별

모두

설명

Inclusion Criteria:

  • Patient aged 18 years old or more,
  • Fluent in spoken and written French,
  • Willing to participate in the study,
  • Hospitalized for heart failure in one of the participating centers for at least 2 days,
  • Affiliated with a French social security scheme
  • Discharged either to home or transferred to a Medical and Rehabilitation Care unit.

Exclusion Criteria:

  • Hospitalized for a reason other than heart failure,
  • Previously included in the study during a prior hospitalization,
  • Presenting with identified cognitive impairment,
  • In a situation deemed inappropriate by the care team (end of life),
  • Living in an institutional setting,
  • Pregnant women,
  • Breastfeeding women,
  • Under legal protective measures,
  • Enrolled in another interventional research study that may interfere with the results of the present study, according to the investigator's judgment.

공부 계획

이 섹션에서는 연구 설계 방법과 연구가 측정하는 내용을 포함하여 연구 계획에 대한 세부 정보를 제공합니다.

연구는 어떻게 설계됩니까?

디자인 세부사항

  • 주 목적: 지지 요법
  • 할당: 무작위화되지 않음
  • 중재 모델: 병렬 할당
  • 마스킹: 없음(오픈 라벨)

무기와 개입

참가자 그룹 / 팔
개입 / 치료
간섭 없음: Standard therapeutic patient education group

Participants in the control group will receive usual care in the cardiology department.

The multidisciplinary usual care involves both medical professionals (including cardiologists and pharmacists) and allied health professionals (including advanced practice nurses, registered nurses, dietitians, and physical activity specialists). Usual care is integrated into the heart failure care pathway, ensuring continuity between community-based and hospital care, hospitalization, and ongoing management at home.

During hospitalization, participants will receive standard therapeutic patient education as well as a routine nurse-led follow-up consultation 30 days after hospital discharge. Patients will also receive the standard discharge documents, together with the usual information and advice provided at discharge.

실험적: Discharge education group

Participants will receive usual care (as described for the control group), supplemented by a structured discharge education intervention delivered by research nurses trained in therapeutic patient education.

The intervention includes :

  1. An initial educational assessment (≈1 h) on the day after enrollment to identify individualized learning needs for discharge and assess key self-management and safety competencies ;
  2. An interactive discharge education session (≈1 h) within 24 hours before discharge, using the teach-back method to reinforce warning signs, medication, self-care, follow-up, and healthcare contacts ;
  3. A nurse-led follow-up telephone call 7 (±3) days after discharge (15-30 min) to assess competencies and reinforce learning if needed ;
  4. A final educational assessment (≈1 h) during the routine 30-day (±7 days) follow-up consultation. Informal caregivers will be invited to participate whenever possible.

연구는 무엇을 측정합니까?

주요 결과 측정

결과 측정
측정값 설명
기간
Unplanned all-cause rehospitalizations, including emergency department visits.
기간: At 30 days after hospital discharge

Rehospitalization is defined as "an unplanned hospital stay of at least one overnight stay"

At 30 days after hospital discharge

2차 결과 측정

결과 측정
측정값 설명
기간
Patient death
기간: At 30 days after hospital discharge
At 30 days after hospital discharge
Number of consultations with the patient's primary care physician.
기간: At 30 days after hospital discharge
At 30 days after hospital discharge
Number of alerts and number of medically managed alerts, generated through remote monitoring for patients enrolled in telemonitoring
기간: At 30 days after hospital discharge
At 30 days after hospital discharge
Unplanned rehospitalizations, including emergency department visits, for heart failure.
기간: At 30 days after hospital discharge

Rehospitalizations are assessed using the European Society of Cardiology definition of hospitalization for heart failure. Those that meet the criteria of this definition are classified as heart failure-related readmissions.

At 30 days after hospital discharge
Patient satisfaction of the hospital discharge organization
기간: At 30 days after hospital discharge

Assessed using the score for the "Discharge Organization" subscale of the French National Authority for Health (HAS) "e-Satis+48h MCO" self-administered questionnaire, which evaluates the experience of patients hospitalized for more than 48 hours in medicine, surgery, or obstetrics.

The "Discharge Organization" subscale consists of 10 items, from which a score ranging from 0 to 100 is calculated, with 0 indicating the poorest experience and 100 indicating the best possible experience.

At 30 days after hospital discharge
Number of scheduled readmissions not carried out.
기간: At 30 days after hospital discharge
At 30 days after hospital discharge
Number of scheduled consultations with a cardiologist (including appointments made)
기간: At 30 days after hospital discharge
At 30 days after hospital discharge
Daily adherence to cardiovascular medication
기간: At baseline

Assessed using the score from the MASCARD self-administered questionnaire. This questionnaire consists of 5 items, from which a score ranging from 0 to 5 is calculated, with 0 indicating major difficulties with medication adherence and 5 indicating few or no difficulties with medication adherence.

At baseline
Daily adherence to cardiovascular medication
기간: At 30 days after hospital discharge

Assessed using the score from the MASCARD self-administered questionnaire. This questionnaire consists of 5 items, from which a score ranging from 0 to 5 is calculated, with 0 indicating major difficulties with medication adherence and 5 indicating few or no difficulties with medication adherence.

At 30 days after hospital discharge
Number of warning signs and self-care behaviors cited by the patient.
기간: At 30 days after hospital discharge

Warning signs : Shortness of breath - Rapid weight gain - Lower limb edema - Fatigue Sel-care behaviors: Physical activity - Weighing oneself - Medication adherence - Avoiding added salt

At 30 days after hospital discharge
Heart failure self-care behaviors
기간: At baseline

Assessed using the score from the self-administered European Heart Failure Self-Care Behaviour Scale-9 (EHFScBS-9) questionnaire. This questionnaire consists of 9 items, from which a score ranging from 9 to 45 is calculated, with higher scores indicating poorer self-care behaviours.

At baseline
Heart failure self-care behaviors
기간: At 30 days after hospital discharge

Assessed using the score from the self-administered European Heart Failure Self-Care Behaviour Scale-9 (EHFScBS-9) questionnaire. This questionnaire consists of 9 items, from which a score ranging from 9 to 45 is calculated, with higher scores indicating poorer self-care behaviours.

At 30 days after hospital discharge
Completeness rate of remote monitoring data transmission for patients enrolled in telemonitoring
기간: At 30 days after hospital discharge

Body weight measured in kilograms (kg) Blood pressure measured in millimetres of mercury (mmHg) Oxygen saturation measured as a percentage (%)

At 30 days after hospital discharge
Self-perceived patient competence in disease management
기간: At baseline

Assessed using a 0-5 "skills star" scale (management of medications, management of follow-up appointments, recognition of warning signs, and implementation of self-care behaviors).

At baseline
Self-perceived patient competence in disease management
기간: At 30 days after hospital discharge

Assessed using a 0-5 "skills star" scale (management of medications, management of follow-up appointments, recognition of warning signs, and implementation of self-care behaviors).

At 30 days after hospital discharge
Self-perceived patient competence in contacting and alerting the care team when experiencing difficulties in their care pathway
기간: At baseline

Assessed using a 0-5 "skills star" scale (communication with healthcare professionals).

At baseline
Self-perceived patient competence in contacting and alerting the care team when experiencing difficulties in their care pathway
기간: At 30 days after hospital discharge

Assessed using a 0-5 "skills star" scale (communication with healthcare professionals).

At 30 days after hospital discharge
Anxiety and depression of patients
기간: At baseline

Assessed using scores from the Hospital Anxiety and Depression Scale (HADS) self-administered questionnaire, which consists of 14 items divided into 7-item "HADS Anxiety" and "HADS Depression" subscales. The total score for each subscale ranges from 0 to 21, with higher scores indicating a higher frequency of anxiety or depression symptoms.

At baseline
Anxiety and depression of patients
기간: At 30 days after hospital discharge

Assessed using scores from the Hospital Anxiety and Depression Scale (HADS) self-administered questionnaire, which consists of 14 items divided into 7-item "HADS Anxiety" and "HADS Depression" subscales. The total score for each subscale ranges from 0 to 21, with higher scores indicating a higher frequency of anxiety or depression symptoms.

At 30 days after hospital discharge
Informal caregiver burden
기간: At baseline

Assessed using the score from the Mini-Zarit Burden Interview. This self-administered questionnaire consists of 7 items, yielding a score ranging from 0 to 7, with 0 indicating absent or mild caregiver burden and 7 indicating severe caregiver burden.

At baseline
Informal caregiver burden
기간: At 30 days after hospital discharge

Assessed using the score from the Mini-Zarit Burden Interview. This self-administered questionnaire consists of 7 items, yielding a score ranging from 0 to 7, with 0 indicating absent or mild caregiver burden and 7 indicating severe caregiver burden.

At 30 days after hospital discharge
Cost of training nurses in discharge education
기간: At 30 days after hospital discharge

Cost of training nurses in discharge education (euros) to allow the economic analysis

At 30 days after hospital discharge
Cost of delivering the discharge education (euros) to allow the economic analysis
기간: At 30 days after hospital discharge

Cost of delivering the discharge education, calculated as the duration of the discharge education multiplied by the fully loaded hourly cost of a nurse's salary.

At 30 days after hospital discharge
Cost of the telephone follow-up call(s) 7 days after hospital discharge (euros)
기간: At 30 days after hospital discharge

Cost of the telephone follow-up call(s) 7 days after hospital discharge, calculated as the duration of the discharge education multiplied by the nurse's fully loaded hourly salary cost.

At 30 days after hospital discharge

공동 작업자 및 조사자

여기에서 이 연구와 관련된 사람과 조직을 찾을 수 있습니다.

스폰서

수사관

  • 수석 연구원: Marie Sophie CHERILLAT, University Hospital, Clermont-Ferrand

간행물 및 유용한 링크

연구에 대한 정보 입력을 담당하는 사람이 자발적으로 이러한 간행물을 제공합니다. 이것은 연구와 관련된 모든 것에 관한 것일 수 있습니다.

일반 간행물

유용한 링크

연구 기록 날짜

이 날짜는 ClinicalTrials.gov에 대한 연구 기록 및 요약 결과 제출의 진행 상황을 추적합니다. 연구 기록 및 보고된 결과는 공개 웹사이트에 게시되기 전에 특정 품질 관리 기준을 충족하는지 확인하기 위해 국립 의학 도서관(NLM)에서 검토합니다.

연구 주요 날짜

연구 시작 (실제)

2026년 10월 29일

기본 완료 (추정된)

2028년 4월 1일

연구 완료 (추정된)

2028년 4월 1일

연구 등록 날짜

최초 제출

2026년 7월 10일

QC 기준을 충족하는 최초 제출

2026년 7월 10일

처음 게시됨 (실제)

2026년 7월 15일

연구 기록 업데이트

마지막 업데이트 게시됨 (실제)

2026년 11월 6일

QC 기준을 충족하는 마지막 업데이트 제출

2026년 11월 3일

마지막으로 확인됨

2026년 11월 1일

추가 정보

이 연구와 관련된 용어

추가 관련 MeSH 약관

기타 연구 ID 번호

  • PHRIP 2024 CHERILLAT
  • 2025-A02457-42 (기타 식별자: ANSM)

개별 참가자 데이터(IPD) 계획

개별 참가자 데이터(IPD)를 공유할 계획입니까?

아니요

약물 및 장치 정보, 연구 문서

미국 FDA 규제 의약품 연구

아니

미국 FDA 규제 기기 제품 연구

아니

이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .