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Trial registered on ANZCTR
Registration number
ACTRN12623000019606
Ethics application status
Approved
Date submitted
7/12/2022
Date registered
10/01/2023
Date last updated
7/06/2023
Date data sharing statement initially provided
10/01/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
BANDAIDS CDSS: Digital solutions for heart failure best practice care.
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Scientific title
The efficacy of digital solutions for heart failure best practice care.
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Secondary ID [1]
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None
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Universal Trial Number (UTN)
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Trial acronym
BANDAIDS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Heart failure with reduced ejection fraction (left ventricular ejection fraction (LVEF) less than or equal to 40% or described as at least “moderately” impaired).
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Condition category
Condition code
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
The BANDAID digital health solution is comprised of a Clinical Decision Support System (CDSS). Physicians will enter in specific patient in-puts into the CDSS, a web-application that will aide in the identification of recommended therapies in hospital inpatients. This will be presented as a list of the guideline-recommended treatments for the clinician to review, indicate if they prescribed the therapy, and why or why not. The CDSS is implemented within 24h of patient admission to hospital and 24h prior to discharge. Use of the CDSS takes approximately 5 minutes and this web application has been specifically developed for this study.
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Intervention code [1]
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Treatment: Other
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Comparator / control treatment
The real-time audit using the CDSS will be compared to a retrospective audit of the same institution, of prescribing practice prior to introduction of the CDSS, to evaluate the effect of the CDSS application on clinician prescribing practice. The retrospective audit period is 6-months prior to CDSS implementation.
There is no control for the e-TIP intervention.
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Control group
Historical
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Outcomes
Primary outcome [1]
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The absolute difference in the proportion of patients receiving guideline recommended therapies at discharge in the real-time audit, compared with rates documented in the retrospective audits. Source of information is the medical record.
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Assessment method [1]
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Timepoint [1]
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Baseline (time of patient discharge from hospital).
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Secondary outcome [1]
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Utilisation of evidence-based therapies post-discharge compared to guideline recommendations in each audit. Source of information is the medical record.
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Assessment method [1]
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Timepoint [1]
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6 months post-discharge.
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Secondary outcome [2]
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Number of HFrEF hospital re-admissions. Source of information is the medical record.
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Assessment method [2]
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Timepoint [2]
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6 months post-discharge.
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Secondary outcome [3]
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Number of HFrEF hospital re-admissions and cardiovascular deaths, as a composite outcome. Source of information is the medical record.
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Assessment method [3]
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Timepoint [3]
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6 months post-discharge.
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Secondary outcome [4]
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Number of cardiovascular hospitalisations. Source of information is the medical record.
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Assessment method [4]
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Timepoint [4]
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6 months post-discharge.
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Secondary outcome [5]
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All-cause mortality. Source of information is the medical record.
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Assessment method [5]
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Timepoint [5]
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6 months post-discharge.
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Eligibility
Key inclusion criteria
Adults, aged 18 years and older, admitted to a participating centre, with a diagnosis of HFrEF confirmed by evidence of left ventricular ejection fraction (LVEF) less than or equal to 40% (or described as at least moderately impaired).
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Minimum age
18
Years
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Maximum age
No limit
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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. Inpatients being managed with palliative intent, or who did not survive admission
2. List of discharge medications unavailable
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Study design
Purpose of the study
Educational / counselling / training
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Allocation to intervention
Non-randomised 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
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The study aims to recruit 500 participants in the real-time study. With 500 participants followed for an average of 6 months, the study offers more than 88% power at 2P=0.05 to detect absolute improvements in adherence rates with any recommendation of 10% or more in the cohort (i.e., from 80% to 90%). Comparisons of hospital re-admission rates for heart failure will be undertaken between the real-time audit cohort and the retrospective audit cohort. A reduction in re-admission rates from 18% to 11.5% or lower would be identified with more than 83% power at 2P=0.05. 500 participants will be recruited to the retrospective audit.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/07/2023
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Actual
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Date of last participant enrolment
Anticipated
31/12/2023
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Actual
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Date of last data collection
Anticipated
30/06/2024
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Actual
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Sample size
Target
500
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Medical Research Future Fund
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Address [1]
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Department of Health and Aged Care
GPO Box 9848
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Sydney
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Address
NHMRC Clinical Trials Centre
92-94 Parramatta Road,
Camperdown NSW 2050
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Sydney Local Health District HREC
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Ethics committee address [1]
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Research Ethics and Governance Office (REGO) Royal Prince Alfred Hospital Missenden Road Camperdown NSW 2050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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06/12/2022
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Approval date [1]
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22/05/2023
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Ethics approval number [1]
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Summary
Brief summary
Heart failure is a major burden in Australia in terms of morbidity, mortality and healthcare expenditure. While multiple guideline-based therapies are recommended for heart failure with reduced ejection fraction (HFrEF), they are underutilised and thus ineffective. This study will develop, deploy and evaluate a digital solution, to improve adherence to guideline-based therapies at time of discharge and decrease admissions and mortality in recently admitted HFrEF patients. The BANDAID digital health solution is comprised of a Clinical Decision Support System (CDSS). Physicians will enter specific patient inputs into the CDSS, which will aide in the identification of recommended therapies for hospital inpatients. The primary objective is to determine if use of the Clinical Decision Support System (CDSS) will improve practitioner adherence to guideline-based therapies in recently admitted HFrEF patients, when compared to rates documented in a quality assurance audit in the same institutions.
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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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Prof Anthony Keech
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Address
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NHMRC Clinical Trials Centre
92-94 Parramatta Road
Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 9562 5000
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Anthony Keech
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Address
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NHMRC Clinical Trials Centre
92-94 Parramatta Road
Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 9562 5000
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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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Anthony Keech
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Address
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NHMRC Clinical Trials Centre
92-94 Parramatta Road
Camperdown NSW 2050
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Country
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Australia
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Phone
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+61 2 9562 5000
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
This 6-month trial is funded by an incubator grant and will be extended to a larger randomised controlled trial (RCT) if the results provide evidence of intervention effectiveness. Given this, IPD data will not be shared from this trial but this would be considered if it were to progress to a larger RCT.
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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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