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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04966117
Registration number
NCT04966117
Ethics application status
Date submitted
29/06/2021
Date registered
19/07/2021
Titles & IDs
Public title
Risk-guided Disease Management in Coronary Artery Disease
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Scientific title
A Risk-guided Disease Management and Tele-rehabilitation Program to Reduce Re-admissions in Coronary Artery Disease (Risk-Guided CAD)
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Secondary ID [1]
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266/21
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Universal Trial Number (UTN)
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Trial acronym
Risk-CAD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Coronary Artery Disease
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Chronic Disease
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Nurse's Role
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Condition category
Condition code
Cardiovascular
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Coronary heart disease
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Cardiovascular
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
BEHAVIORAL - Risk-Guided DMP
BEHAVIORAL - Usual Care
Experimental: Risk-Guided DMP - The intervention is a 12 month disease management program after hospital discharge for coronary artery disease that is overseen by a cardiac nurse.
Active comparator: Usual Care - Usual care patients will receive standard cardiology care.
BEHAVIORAL: Risk-Guided DMP
Patients will be assigned a cardiac nurse to help manage their heart condition who will:
1. develop a care plan and communicate with the patients' General Practitioner (GP) and cardiologist about management, particularly medications to help control risk factors.
2. provide health coaching at pre-specified times over 12 months via telehealth (phone or video call) to ensure that patient's take their medications as prescribed and to give health education and guidance on lifestyle changes.
3. facilitate cardiac rehabilitation via a smart phone or tablet app (called SmartCR). This app monitors health and physical activity, has prompted tasks to do and delivers education via video, audio and written articles. The information from this app can be used by the cardiac nurse during telehealth follow-up.
4. invite participation to a supervised 6-week group exercise program which will require using our on-site gym.
BEHAVIORAL: Usual Care
Usual care patients will receive standard cardiology care as scheduled that includes adherence to guideline-based care (medications and physical activity), education (self-care), a treatment plan to manage co-morbidities, early post-discharge follow-up/support and routine preventative care.
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Intervention code [1]
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BEHAVIORAL
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Hospitalization or death
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Assessment method [1]
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Unplanned all-cause hospital readmission or death
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Timepoint [1]
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90 days post discharge
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Secondary outcome [1]
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Hospitalization or death
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Assessment method [1]
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Short term unplanned all-cause hospital readmission or death
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Timepoint [1]
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30 days post discharge
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Secondary outcome [2]
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Provider adherence to best practice guidelines
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Assessment method [2]
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Increased prescription of lipid-lowering, anti-hypertensive (e.g. beta-blocker) and antiplatelet agents
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Timepoint [2]
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12 months post discharge
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Secondary outcome [3]
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Risk factor control - lipids
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Assessment method [3]
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Change in LDL-cholesterol (mmol/L)
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Timepoint [3]
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12 months post discharge
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Secondary outcome [4]
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Risk factor control - blood pressure
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Assessment method [4]
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Change in systolic and diastolic blood pressure (mmHg)
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Timepoint [4]
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12 months post discharge
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Secondary outcome [5]
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Health well-being
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Assessment method [5]
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Change in quality of life (via AQoL-8D total scores and 8 dimension scores)
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Timepoint [5]
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12 months post discharge
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Eligibility
Key inclusion criteria
1. Aged between 30 to 74 years; AND
2. Hospitalised with CAD or other eligible cardiac procedure or condition including acute myocardial infarction (STEMI or NSTEMI), unstable angina, coronary artery bypass grafting or percutaneous coronary intervention; AND
3. Defined as higher risk (score >= 5) by PEGASUS-TIMI 54 criteria; AND
4. Eligible for Medicare.
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Minimum age
30
Years
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Maximum age
74
Years
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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. Inability to provide written informed consent; OR
2. Non-English speaking; OR
3. Inability to attend clinic visits; OR
4. Inability to engage with an app due to low technical literacy or lacking access to a smart phone or wi-fi; OR
5. Hospitalised with a primary diagnosis of heart failure; OR
6. eGFR <30 ml/min/1.73m2 (CKD stage 4 or stage 5); OR
7. Valve disease only; OR
8. Requiring palliative care; OR
9. Concomitant terminal non-cardiac illnesses that could influence 12-month prognosis (e.g. advanced malignancy); OR
10. Participating in another study with a potential but unknown effect on outcome.
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Study design
Purpose of the study
Prevention
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
17/07/2021
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
31/08/2025
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Actual
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Sample size
Target
270
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Baker Heart and Diabetes Institute - Melbourne
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Recruitment postcode(s) [1]
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3004 - Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
Baker Heart and Diabetes Institute
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Heartwest
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Address [1]
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Country [1]
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Other collaborator category [2]
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Other
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Name [2]
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University of Melbourne
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Address [2]
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Country [2]
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Other collaborator category [3]
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Other
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Name [3]
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Queen's University, Belfast
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Address [3]
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Country [3]
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Other collaborator category [4]
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Other
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Name [4]
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Western Health
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Address [4]
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Country [4]
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Ethics approval
Ethics application status
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Summary
Brief summary
Coronary artery disease (CAD) is the number one killer of Australians with a high risk for a recurrent event(s) and hospital readmission. Many of these readmissions can be prevented with better management to control the problem of CAD. A disease management program, led by nurses who interact with other health professionals/providers, can help with education and counselling, taking medications correctly and making healthy lifestyle changes for higher risk patients. Newer models of disease management programs make use of mobile devices (such as an "app") and telehealth (by phone or video call) to monitor and manage health which could facilitate CAD management. Therefore, the aim of this study is to test this type of disease management program (DMP) compared to standard care for reducing hospital readmissions or death in people with CAD who are at high risk of being readmitted. The Investigators envisage that a novel Risk-Guided DMP will be favorable to patients and associated with high-level participation. The Investigators hypothesize that high-risk patients randomized to Risk-Guided CAD will have reduced hospital readmissions or death compared with those randomized to usual care.
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Trial website
https://clinicaltrials.gov/study/NCT04966117
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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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Melinda J Carrington, PhD
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Address
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Baker Heart and Diabetes Institute
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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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Melinda J Carrington, PhD
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Address
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Country
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Phone
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+61 3 8532 1638
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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
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
The data to be shared will be all of the individual participant data collected during the trial, after de-identification and underlying published results only. The data will be available to only researchers who provide a methodologically sound proposal, case-by-case basis at the discretion of Principal Investigator. The data will be available for any approved purpose.
Supporting document/s available: Study protocol, Informed consent form (ICF)
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When will data be available (start and end dates)?
Immediately following publication; no end date.
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Available to whom?
Access subject to approvals by Principal Investigator.
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Available for what types of analyses?
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How or where can data be obtained?
IPD available at link: http://baker.edu.au/research/laboratories/preclinical-disease-prevention
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What supporting documents are/will be available?
No Supporting Document Provided
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Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/17/NCT04966117/Prot_000.pdf
Informed consent form
https://cdn.clinicaltrials.gov/large-docs/17/NCT04966117/ICF_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04966117