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Trial registered on ANZCTR
Registration number
ACTRN12606000371594
Ethics application status
Approved
Date submitted
19/08/2006
Date registered
25/08/2006
Date last updated
3/03/2008
Type of registration
Prospectively registered
Titles & IDs
Public title
Take Heart in Primary Care Study
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Scientific title
A cluster randomised controlled trial designed to investigate the impact on the prevalence and severity of depression, in patients with chronic manifestations of ischaemic heart disease.
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Secondary ID [1]
302
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National Health and Medical Research Council (NHMRC): 361324
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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 ischaemic heart disease
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Comorbid depression
1340
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Condition category
Condition code
Cardiovascular
1427
1427
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0
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Other cardiovascular diseases
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Mental Health
1428
1428
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0
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Depression
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A comprehensive three-part program of: 1)screening for depression in primary care patients requiring ongoing management of chronic manifestations of ischaemic heart disease; 2) academic detailing of best-practice guidelines for managing depression; and 3) patient-specific psychiatric advice to the treating GP with follow-up screening and advice, relative to usual GP management.
Duration of study: 12 months.
Depression will be determined via the Centre for Epidemiologic Studies-Depression Scale (CES-D) and the Arroll (2 question) scale.
All study patients will be screened at baseline and 12 months. Patients in the intervention group, and depressed, will be rescreened at 3, 6 and 9 months as required.
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Intervention code [1]
1317
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Diagnosis / Prognosis
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Comparator / control treatment
No comparator.
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Control group
Active
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Outcomes
Primary outcome [1]
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Proportion of surviving patients with chronic manifestations of ischaemic heart disease who are depressed
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Assessment method [1]
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Timepoint [1]
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At the completion of 12 months follow-up
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Primary outcome [2]
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A major, and related outcome, is the proportion of patients with mild versus moderate to severe depression and the proportion of initially non depressed patients who display depressive symptoms
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Assessment method [2]
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Timepoint [2]
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At 12 months
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Secondary outcome [1]
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1) Prevalence, severity and natural history of depression in a patient cohort being treated for chronic manifestations of ischaemic heart disease in primary care.
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Assessment method [1]
3420
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Timepoint [1]
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Examined at baseline, 3,6,9 and 12 months and data will be collated and assessed at the completion of 12 months.
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Secondary outcome [2]
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2) Effects of a pragmatic GP focussed screening and intervention program on the severity of depression, and effects on the overall management of chronic manifestations of ischaemic heart disease, risk factor profile, angina pectoris (AP) and heart failure (HF) specific clinical health outcomes, patient wellbeing and quality of life, treatment adherence patterns, and morbidity and mortality.
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Assessment method [2]
3421
0
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Timepoint [2]
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At 12 months.
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Secondary outcome [3]
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3) Health related quality of life will be reassessed via the SF-12 and EQ-5D, the latter measure providing utility scores and quality adjusted life years (QALYs) for a cost utility analysis.
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Assessment method [3]
3422
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Timepoint [3]
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At 12 months followup.
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Eligibility
Key inclusion criteria
(GPs):All South Australian urban and urban fringe general practices,computerised, minimum of three full-time equivalent GPs, general practice nurse, offering physical space for screening.Inclusion criteria (patients):a diagnosis of ischaemic heart disease in the preceeding 6 months and requiring ongoing management for manifestations of ischaemic heart disease, particularly angina pectoris and/or heart failure, must attend the practice, speak and understand english, have intact cognitive function and be willing to provide informed consent.
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Minimum age
18
Years
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Maximum age
85
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
(Patients):a psychotic illness or communication deficit precluding communication with the GP, planned correction of underlying cardiovascular disease state (eg coronary artery bypass grafting or heart transplant) or acute hospital admission for any cardiovacular reason in past 3 months.
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Study design
Purpose of the study
Diagnosis
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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)
Randomisation organised and maintained centrally by colleague not directly involved with running of study
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Cluster randomisation. Unit of randomisation:general practice. Stratified by GP division. Random numbers generated by computer.
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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
Recruiting
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Date of first participant enrolment
Anticipated
18/09/2006
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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
Anticipated
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Actual
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Sample size
Target
604
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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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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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General Practice Research Initiatives Section, Office of NHMRC
MDP 33, GPO Box 9848
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Government body
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Name
NHMRC
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Address
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Country
Australia
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Secondary sponsor category [1]
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University
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Name [1]
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The University of Queensland
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Address [1]
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Herston Road, Brisbane. QLD 4066
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Country [1]
1372
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Australia
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Other collaborator category [1]
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University
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Name [1]
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University of Adelaide
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Address [1]
220
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North Terrace, Adelaide. SA 5000
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Country [1]
220
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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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The University of Queensland
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Ethics committee address [1]
2991
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Ethics committee country [1]
2991
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Australia
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Date submitted for ethics approval [1]
2991
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Approval date [1]
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19/05/2006
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Ethics approval number [1]
2991
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2006000270
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Ethics committee name [2]
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The University of Adelaide
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Ethics committee address [2]
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North Terrace, Adelaide. SA
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Ethics committee country [2]
5128
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Australia
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Date submitted for ethics approval [2]
5128
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Approval date [2]
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24/10/2006
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Ethics approval number [2]
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H-126-2006
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Summary
Brief summary
Heart disease is Australia's biggest health problem, affecting nearly 3.7 million people every year. Recent research has shown that emotional problems such as depression can make heart problems worse. However, it is often difficult to diagnose depression in people with heart problems. This research aims to improve the general health and wellbeing of people with chronic heart problems and depression by determining whether a special general practitioner enhanced education program, comprising the monitoring of depression, academic detailing of best-practice guidelines and psychiatric advice to the treating GP, will reduce depression in people with chronic heart probalems.
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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
27924
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Country
27924
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Phone
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Fax
27924
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Email
27924
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Contact person for public queries
Name
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Kerena Eckert, Postdoctoral Research Fellow
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Address
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School of Medicine
University of Queensland
Herston Road, Herston QLD 4006
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Country
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Australia
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Phone
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0405 182 391
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Fax
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61 8 8222 6025
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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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Professor Simon Stewart
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Address
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Baker Heart Research Institute
PO Box 6492
St Kilda Road, Central 8008
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Country
1434
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Australia
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Phone
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61 3 9276 2903
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Fax
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61 3 9251 1837
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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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