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Smartphone GUIded MeDication AdherencE and Rehabilitation in Patients With Coronary Artery Disease (smartGUIDE)

6. september 2018 oppdatert av: Mintu Turakhia, Stanford University

Smartphone GUIded MeDication AdherencE and Rehabilitation in Patients With Coronary Artery Disease (smartGUIDE)

This study evaluates a smartphone-based cardiac rehabilitation program in adults with coronary artery disease. Half of patients will participate in a smartphone-based cardiac rehabilitation program while the other half will receive standard-of-care.

Studieoversikt

Status

Avsluttet

Intervensjon / Behandling

Detaljert beskrivelse

Cardiac rehabilitation as a means to improve lifestyle-based risk factor modification, remains poorly prescribed and utilized, often due to the lack of access to programs, poor insurance coverage, cost, or patient or physician motivational factors. Low-cost solutions that can improve patient adherence to medications, risk factor reduction, and exercise could improve cardiovascular outcomes and cost-effectiveness compared to current care models.

Studietype

Intervensjonell

Registrering (Faktiske)

63

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

    • California
      • Stanford, California, Forente stater, 94305
        • Stanford Healthcare

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion criteria:

I. ≥ 18 years of age

II. Patient at Stanford Health Care with evidence of CAD (atherosclerosis of one or more coronary arteries or clinical evidence or documentation of ischemia, infarction) OR a diagnosis related to CAD (i.e. ischemic heart disease ICD-10-Code: I20-25).

III. Prescription of a P2Y12 antagonist and/or a statin for an anticipated duration of at least 3 months following discharge

IV. Possession of a compatible (iPhone 5s or later; OS 8.1 or higher) smartphone with an active phone number and data plan. The smartphone must be in continued possession of the participant. It may not be a shared device and must exclusively remain in the possession of the participant during the study period. The smartphone must have an active cellular phone number and cellular data subscription. Wi-Fi internet capability is not a substitute for an active cellular data plan.

V. Must sign an informed consent form (ICF) indicating that he or she understands the purpose of, and procedures required for, the study and is willing to participate in the study.

VI. Willing to have the mobile application installed on a smartphone and use it every day during the entire study period VII. Willing to provide oral confirmation indicating that he/she is currently not using a medication adherence application.

VIII. Ability to read and understand English.

Exclusion criteria:

Any potential participant who meets any of the following criteria will be excluded from participating in the study:

I. Anticipated inability to adhere to the mobile application (BrightHeart®) based on opinion of site Principal Investigator (PI).

II. Current use of adherence tracking devices, electronic, smartphone or computer applications, including but not limited to smart pill bottles, pill timers, radiofrequency tagged medications or dispensers, mobile applications, or automated phone reminders. Pill organizers that remind participants when to take medicine with beeps or alerts are exclusion.

a. Note: Pharmacy and health care plan automated refill reminders are permitted and are not exclusion. Pill organizers or containers that only compartmentalize a participant's medications based on days of the week are not exclusion.

III. Cognitive, visual, hearing, voice, or motor impairment that would prevent completion of study procedures or use of mobile phone. Co-morbidities that would preclude participation (e.g. ongoing chemotherapy) or planned hospitalization for complex procedures as determined by the PI (e.g. bypass, valve or aortic surgery, transarterial valve replacement) IV. End-stage of one of the following: heart failure (using left ventricular assist device or listed for heart transplantation), renal disease, lung disease, liver disease.

V. Any condition with a life expectancy less than 3 months. VI. Employee of the investigator or study site, with direct involvement in the proposed study or other studies under the direction of that investigator or study site, as well as family members of the employees or the investigator VII. Any other condition as determined by the PI.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: smartphone-based cardiac rehabilitation
The BrightHeart® mobile application is installed on the smartphone and a heart coach set up and guides the participant through a cardiac care program.
BrightHeart® has two components: smartphone mobile based application and a human coach. It is a combined approach of medication adherence, exercise, diet, sleep and stress reduction.
Ingen inngripen: Control
Standard-of-care alone.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Medication adherence
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
The proportion of days coverd (PDC) expressed as a percentage but considered as a continuous variable of the composite of the prescribed P2Y12 receptor antagonist and/or the statin.
Baseline through End of Study visit - approximately 90 days per participant.

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Medication adherence II
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Proportion of participants with PDC ≥ 80% of the composite of the P2Y12 receptor antagonist and/or the statin
Baseline through End of Study visit - approximately 90 days per participant.
Medication adherence III
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
The PDC of each medication of the composite
Baseline through End of Study visit - approximately 90 days per participant.
Medication adherence IV
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Proportion of participants with PDC ≥ 80% of each of the composite
Baseline through End of Study visit - approximately 90 days per participant.
Medication adherence V
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Mean time from discharge to first fill
Baseline through End of Study visit - approximately 90 days per participant.
Medication persistence
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
proportion of patients with an active prescription at three months of a statin and P2Y12 inhibitor
Baseline through End of Study visit - approximately 90 days per participant.
Cardiovascular risk factors I
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Serum LDL-C at End of Study
Baseline through End of Study visit - approximately 90 days per participant.
Cardiovascular risk factors II
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Proportion of participants within target blood pressure (<140/90 mmHg or <130/80 mmHg for patients with diabetes mellitus or chronic kidney disease) at End of Study
Baseline through End of Study visit - approximately 90 days per participant.
Cardiovascular risk factors III
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Proportion of participants with HbA1c ≤ 7% at End of Study (only if diabetes mellitus was known at time of inclusion)
Baseline through End of Study visit - approximately 90 days per participant.
Cardiovascular risk factors IV
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Change in body weight from baseline to End of Study
Baseline through End of Study visit - approximately 90 days per participant.
Cardiovascular risk factors V
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Change in quality of life (measured by EQ-5D-3L14) from day 3-10 after discharge to End of Study
Baseline through End of Study visit - approximately 90 days per participant.
Cardiovascular risk factors VI
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Change in patient activation (measured by PAM®1015) from day 3-10 after discharge to End of Study
Baseline through End of Study visit - approximately 90 days per participant.
Cardiovascular risk factors VII
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Physical activity at End of Study (measured by a physical acitivity questionnaire)
Baseline through End of Study visit - approximately 90 days per participant.
Exploratory I: Rehospitalization
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
30-day rehospitalization for any reason
Baseline through End of Study visit - approximately 90 days per participant.
Exploratory II: Cardiovascular outcomes
Tidsramme: Baseline through End of Study visit - approximately 90 days per participant.
Major adverse cardiac events (MACE) defined as: Death, myocardial infarction, acute coronary syndrome, out of hospital cardiac arrest, stent thrombosis, repeat revascularization at 90 days
Baseline through End of Study visit - approximately 90 days per participant.

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Hovedetterforsker: Minang (Mintu) Turakhia, MD, Stanford University

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart (Faktiske)

19. juli 2017

Primær fullføring (Faktiske)

9. mai 2018

Studiet fullført (Faktiske)

17. august 2018

Datoer for studieregistrering

Først innsendt

16. juni 2017

Først innsendt som oppfylte QC-kriteriene

30. juni 2017

Først lagt ut (Faktiske)

5. juli 2017

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

10. september 2018

Siste oppdatering sendt inn som oppfylte QC-kriteriene

6. september 2018

Sist bekreftet

1. september 2018

Mer informasjon

Begreper knyttet til denne studien

Plan for individuelle deltakerdata (IPD)

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NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

produkt produsert i og eksportert fra USA

Nei

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