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

6 de setembro de 2018 atualizado por: 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.

Visão geral do estudo

Status

Rescindido

Condições

Intervenção / Tratamento

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Real)

63

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

    • California
      • Stanford, California, Estados Unidos, 94305
        • Stanford Healthcare

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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.

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Prevenção
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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.
Sem intervenção: Control
Standard-of-care alone.

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Medication adherence
Prazo: 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.

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Medication adherence II
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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.

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Investigadores

  • Investigador principal: Minang (Mintu) Turakhia, MD, Stanford University

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

19 de julho de 2017

Conclusão Primária (Real)

9 de maio de 2018

Conclusão do estudo (Real)

17 de agosto de 2018

Datas de inscrição no estudo

Enviado pela primeira vez

16 de junho de 2017

Enviado pela primeira vez que atendeu aos critérios de CQ

30 de junho de 2017

Primeira postagem (Real)

5 de julho de 2017

Atualizações de registro de estudo

Última Atualização Postada (Real)

10 de setembro de 2018

Última atualização enviada que atendeu aos critérios de controle de qualidade

6 de setembro de 2018

Última verificação

1 de setembro de 2018

Mais Informações

Termos relacionados a este estudo

Outros números de identificação do estudo

  • 39555

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

produto fabricado e exportado dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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