- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT07659106
Decision Aid for Anticoagulation Duration After Unprovoked Venous Thromboembolism (DECIDE-VTE)
Enabling and Engaging Patients to Decide Indefinite Versus Short-Term Anticoagulation for Venous Thromboembolism (DECIDE-VTE)
Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a common condition that is typically treated with blood thinners (anticoagulants). After completing at least 3 months of treatment for a first unprovoked or weakly provoked VTE, patients and clinicians must decide whether to stop anticoagulation or continue treatment for a longer period. Continuing anticoagulation reduces the risk of another blood clot but increases the risk of bleeding. Because both options involve important benefits and risks, this decision should reflect the patient's values and preferences.
The DECIDE-VTE study will evaluate whether a patient decision aid can improve decision-making for patients facing this choice. The decision aid provides evidence-based information about the risks and benefits of continuing versus stopping anticoagulation and includes a values clarification exercise to help patients identify what matters most to them.
This multicentre batched stepped-wedge cluster randomized trial will be conducted in 12 thrombosis clinics across Canada. Clinics will transition from usual care to implementation of the patient decision aid according to a randomized schedule. The primary outcome is decisional conflict immediately following the anticoagulation decision visit, measured using the Decisional Conflict Scale. Secondary outcomes include patient knowledge, treatment decisions, decisional regret, concordance with the chosen treatment strategy, recurrent venous thromboembolism, major bleeding, all-cause mortality, and implementation outcomes.
Przegląd badań
Status
Interwencja / Leczenie
Szczegółowy opis
Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is commonly treated with anticoagulation. After completing initial anticoagulation for a first unprovoked or weakly provoked VTE, patients and clinicians must decide whether to discontinue anticoagulation or continue treatment long term. This is a preference-sensitive decision because continued anticoagulation reduces the risk of recurrent VTE but increases the risk of bleeding.
The DECIDE-VTE Patient Decision Aid was developed to support shared decision-making about anticoagulation duration. The tool provides structured information about treatment options, recurrence and bleeding risks, and includes a values-clarification exercise to help patients consider which outcomes and treatment burdens matter most to them.
This study is a pragmatic, multicentre, batched stepped-wedge cluster randomized trial. Participating thrombosis clinics begin in the usual care phase and transition to implementation of the DECIDE-VTE Patient Decision Aid according to a randomized schedule. Randomization occurs at the clinic level to reduce contamination between study conditions and to reflect real-world implementation of the decision aid into routine thrombosis clinic care.
The study will assess whether integrating the DECIDE-VTE Patient Decision Aid into clinical care improves decision quality compared with usual care, and will also evaluate implementation-related measures relevant to future use of the tool in practice.
Typ studiów
Zapisy (Szacowany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Harika Dasari
- Numer telefonu: 5144319353
- E-mail: harika.dasari@rimuhc.ca
Lokalizacje studiów
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Alberta
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Calgary, Alberta, Kanada, T2N 1N4
- University Of Calgary
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Kontakt:
- Jill Baxter
- Numer telefonu: 403-944-5246
- E-mail: jbaxter@ucalgary.ca
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Główny śledczy:
- Leslie Skieth, MD FRCPC
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British Columbia
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Vancouver, British Columbia, Kanada, V5Z 1N1
- Vancouver General Hospital
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Kontakt:
- Edward Wong
- Numer telefonu: 22966 604-875-4111
- E-mail: edward.wong@bccancer.bc.ca
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Główny śledczy:
- Rick Ikesaka, MD MSc. FRCPC DRCPSC
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Ontario
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Ottawa, Ontario, Kanada, K1H 8L6
- Ottawa Hospital - General Campus
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Kontakt:
- Amanda Pecarskie
- Numer telefonu: 78804 6137378899
- E-mail: apecarskie@ohri.ca
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Główny śledczy:
- Deborah Siegal, MD MSc FRCPC
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Quebec
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Montreal, Quebec, Kanada, H3T 1E2
- Sir Mortimer B. Davis Jewish General Hospital
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Kontakt:
- Elena Shulikovsky
- Numer telefonu: 23703 514-340-8222
- E-mail: eshulikovsky@jgh.mcgill.ca
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Montreal, Quebec, Kanada, H4A 3J1
- Research Institute of McGill University Health Centre
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Kontakt:
- Sidra Ahmed
- Numer telefonu: 514-934-1934
- E-mail: Sidra.Ahmed@rimuhc.ca
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
- Dorosły
- Starszy dorosły
Akceptuje zdrowych ochotników
Opis
Inclusion Criteria:
- Age 18 years or older
- First episode of objectively confirmed unprovoked or weakly provoked venous thromboembolism (VTE)
- Objectively confirmed proximal deep vein thrombosis and/or segmental or greater pulmonary embolism
- Completed at least 3 months of therapeutic anticoagulation and currently receiving anticoagulation
- Enrollment within 12 months of diagnosis of the index/qualifying VTE event
- Able to provide written informed consent
- Able to participate in shared decision-making in English or French
Exclusion Criteria:
- Recurrent unprovoked or weakly provoked VTE I(i.e. multiple unprovoked/weakly provoked VTE)
- Index/qualifying VTE is a strongly provoked VTE (e.g., associated with major surgery, major trauma, plaster cast immobilization, or prolonged bed rest)
- Index/qualifying VTE associated with a persistent strong provoking risk factor (e.g., active cancer or ongoing immobility)
- Women at very low recurrence risk (HERDOO2 score 0-1)
- High bleeding risk such that anticoagulation should be discontinued
- Requirement for long-term anticoagulation for another indication (e.g., atrial fibrillation)
- Prior dedicated long-term anticoagulation Decision Visit regarding anticoagulation duration
Plan studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie podtrzymujące
- Przydział: Randomizowane
- Model interwencyjny: Zadanie krzyżowe
- Maskowanie: Brak (otwarta etykieta)
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
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Brak interwencji: Usual Care
Participants receive standard thrombosis clinic care and clinician-patient discussions regarding continuation versus discontinuation of anticoagulation following a first unprovoked or weakly provoked venous thromboembolism.
No structured patient decision aid is used.
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Eksperymentalny: DECIDE-VTE Patient Decision Aid
Participants receive the DECIDE-VTE Patient Decision Aid in addition to usual thrombosis clinic care.
The decision aid provides evidence-based information regarding the risks and benefits of continuing versus discontinuing anticoagulation after a first unprovoked or weakly provoked venous thromboembolism and includes a structured values clarification exercise to support shared decision-making.
Participants and clinicians make the final treatment decision together during the Decision Visit.
|
The DECIDE-VTE Patient Decision Aid is a bilingual (English/French) evidence-based decision support tool designed for adults with a first unprovoked or weakly provoked venous thromboembolism who are deciding whether to continue or discontinue anticoagulation after completing at least 3 months of therapy.
The decision aid presents balanced information regarding the risks and benefits of extended anticoagulation, including risks of recurrent venous thromboembolism and major bleeding, and incorporates a structured values clarification exercise to support shared decision-making between patients and clinicians during the anticoagulation Decision Visit.
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Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Decisional Conflict Scale (DCS) Total Score
Ramy czasowe: Decision Visit (Day 0)
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Decisional conflict measured using the validated 16-item Decisional Conflict Scale (DCS).
Total scores range from 0 to 100, with higher scores indicating greater decisional conflict.
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Decision Visit (Day 0)
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
VTE Knowledge Assessment Score
Ramy czasowe: Decision Visit (Day 0)
|
Patient knowledge regarding recurrent venous thromboembolism and bleeding risks assessed using a 6-item true/false questionnaire.
Scores range from 0 to 6, with higher scores indicating greater knowledge.
|
Decision Visit (Day 0)
|
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Treatment Decision
Ramy czasowe: Decision Visit (Day 0)
|
Patient decision regarding continuation versus discontinuation of anticoagulation therapy.
|
Decision Visit (Day 0)
|
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Decisional Regret Scale (DRS) Score
Ramy czasowe: 3-Month Follow-Up Visit (Day 90 ± 14 days)
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Decisional regret measured using the validated 5-item Decisional Regret Scale (DRS).
Scores range from 0 to 100, with higher scores indicating greater regret regarding the treatment decision.
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3-Month Follow-Up Visit (Day 90 ± 14 days)
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Concordance With Treatment Decision
Ramy czasowe: 3-Month Follow-Up Visit (Day 90 ± 14 days) and 12-Month Follow-Up Visit (Day 365 ± 60 days)
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Agreement between the treatment decision made at the Decision Visit (Day 0) and participant-reported anticoagulant use status at follow-up.
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3-Month Follow-Up Visit (Day 90 ± 14 days) and 12-Month Follow-Up Visit (Day 365 ± 60 days)
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Recurrent Venous Thromboembolism
Ramy czasowe: 12-Month Follow-Up Visit (Day 365 ± 60 days)
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Adjudicated objectively confirmed recurrent venous thromboembolism assessed using the INVENT VERDICT adjudication process.
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12-Month Follow-Up Visit (Day 365 ± 60 days)
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Major Bleeding
Ramy czasowe: 12-Month Follow-Up Visit (Day 365 ± 60 days)
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Adjudicated objectively confirmed major bleeding defined according to International Society on Thrombosis and Haemostasis criteria.
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12-Month Follow-Up Visit (Day 365 ± 60 days)
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All-Cause Mortality
Ramy czasowe: 12-Month Follow-Up Visit (Day 365 ± 60 days)
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Death from any cause identified through medical record review and, where necessary, provincial vital statistics records.
|
12-Month Follow-Up Visit (Day 365 ± 60 days)
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Inne miary wyników
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Patient Decision Aid Use Time
Ramy czasowe: Decision Visit (Day 0)
|
Time in minutes spent interacting with the DECIDE-VTE Patient Decision Aid.
|
Decision Visit (Day 0)
|
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Physician Visit Duration
Ramy czasowe: Decision Visit (Day 0)
|
Time in minutes from the participant entering the clinic room with the physician until completion of the clinical encounter.
|
Decision Visit (Day 0)
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Współpracownicy i badacze
Śledczy
- Główny śledczy: Marc Rodger, MD MSc FRCPC, McGill University
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Szacowany)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
Dodatkowe istotne warunki MeSH
Inne numery identyfikacyjne badania
- DECIDE-VTE-SWRCT
- 202509PJT-552796-CID-CFAC-5562 (Inny identyfikator: Canadian Institute of Health Research)
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Ramy czasowe udostępniania IPD
Kryteria dostępu do udostępniania IPD
Typ informacji pomocniczych dotyczących udostępniania IPD
- PROTOKÓŁ BADANIA
- SOK ROŚLINNY
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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