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Trial registered on ANZCTR
Registration number
ACTRN12606000383561
Ethics application status
Approved
Date submitted
10/08/2006
Date registered
30/08/2006
Date last updated
2/06/2009
Type of registration
Retrospectively registered
Titles & IDs
Public title
THE MAXIMISE STUDY
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Scientific title
Effectiveness of a specialist nurse supervised titration clinic on titration of beta blocker therapy in patients with chronic heart failure (CHF)
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic (systolic) heart failure
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Condition category
Condition code
Cardiovascular
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Nurse Supervised Titration Clinic for beta blocker titration. Those randomised to the Nurse Supervised Titration Clinic will attend appointments as needed to achieve maximum tolerated dose of beta blocker as quickly as possible within a 6 month period. At each visit (taking approximately 1 hour) the nurse will assess the patient, determine appropriate medication changes and provide education. All changes to treatment will be approved by medical staff in the Heart Function Clinic. Recommendations for beta blocker up titration will be provided to the GP by HFC medical staff.
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Intervention code [1]
1275
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Other interventions
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Comparator / control treatment
Usual Care (GP plus as needed specialist Heart Function Clinic (HFC) attendance) for beta blocker titration. Patients randomised to Usual Care will be seen in the HFC at baseline, 3 months and 6 months.
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Control group
Active
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Outcomes
Primary outcome [1]
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Time to maximum dose beta blockers
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Assessment method [1]
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Timepoint [1]
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Documented at 6 months
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Secondary outcome [1]
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Maximum dose beta blocker achieved
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Assessment method [1]
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Timepoint [1]
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Documented at 6 months
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Secondary outcome [2]
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Mean dose beta blocker at 6 months
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Assessment method [2]
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Timepoint [2]
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Documented at 6 months
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Eligibility
Key inclusion criteria
1. CHF with beta blocker therapy at less than half target dose requiring up-titration2. Left ventricular (LV) systolic dysfunction as documented by RNVG or echocardiography3. Written informed consent prior to enrolment.
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Minimum age
18
Years
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Maximum age
Not stated
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Previously failed an up-titration of beta blocker in the previous six months2. Medically inappropriate for up-titration of beta blockers in a nurse supervised heart filaure titration clinic.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Computer generated random numbers held in sealed envelopes by a third party.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Groups balanced after every six patients using the block method outlined by Peto et al (1976).
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/03/2006
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
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Actual
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Sample size
Target
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Austin Hospital Medical Research Foundation: in-house research funds of A/Prof David L.
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Address [1]
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Studley Road
HEIDELBERG, 3084 VICTORIA
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Country [1]
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Australia
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Funding source category [2]
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Commercial sector/Industry
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Name [2]
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Roche Products
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Address [2]
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81-89 Hotham Road
KEW, VICTORIA
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Country [2]
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Australia
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Primary sponsor type
Individual
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Name
In-house (Austin Hospital Medical Research Foundation) research funds of A/Prof David L. Hare
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Address
Studley Road
HEIDELBERG, 3084 VICTORIA
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Country
Australia
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Secondary sponsor category [1]
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Commercial sector/Industry
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Name [1]
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Roche Products Pty Ltd
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Address [1]
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81-89 Hotham Road
KEW, VICTORIA
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Austin Health
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Ethics committee address [1]
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
3003
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Approval date [1]
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06/01/2006
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Ethics approval number [1]
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H2006/02397
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Summary
Brief summary
Chronic heart failure (CHF) occurs when the heart is unable to supply enough blood to meet the needs of the body. Common symptoms of CHF include breathlessness, fatigue and swelling of the lower legs. Clinical trials have shown several drug treatments (in particular, beta blockers) to be beneficial in reducing hospital admissions, and improving length and quality of life. In all the major clinical trials beta blocker therapy has been started and gradually increased to a target dose (or the maximum tolerated dose) over the course of several weeks. International and national expert guidelines recommend that patients with CHF be prescribed a beta blocker, however the benefits of beta blocker therapy cannot be assumed to follow when the doses used in the clinical trials have not been reached. For this reason it is important to ensure that patients receive the highest tolerated dosage. Also, there are data from some trials that suggest that the benefits of beta-blockade are detectable within the first few weeks. Thus any delay in the commencement and increase to maximum dose should be minimized. The aim of this study is to determine whether patients attending a specialist Nurse Supervised Titration Clinic reach higher doses of beta blocker sooner than patients receiving Usual Care. Usual Care involves visits to the Heart Function Clinic doctor every 3 months with visits to the GP in between.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Deidre Toia
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Address
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Research Coordinator
Department of Cardiology HSB Level 5
Austin Health
Studley Rd,
Heidelberg VIC 3084
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Country
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Australia
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Phone
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+61 3 94963652
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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A/Prof David L. Hare
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Address
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Director of Research
Department of Cardiology HSB Level 5
Austin Health
Studley Rd,
Heidelberg VIC 3084
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Country
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Australia
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Phone
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+61 3 94963815
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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