Caregiver Enhanced Assistance and Support for the Elderly Heart Failure Patient at Hospital Discharge (CEASE-HF)

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McMaster University

Status

Completed

Conditions

Heart Failure

Treatments

Other: Digital talking scale
Other: Standardized Heart Failure Discharge Summary to Primary Care Physicians©
Behavioral: Standardized education sessions
Other: Usual care
Other: Heart Failure Diuretic Decision Support Tool for Patient Self Management©

Study type

Interventional

Funder types

Other

Identifiers

NCT01886534
11-638

Details and patient eligibility

About

Close to ninety percent of older heart failure (HF) patients have some cognitive deficits at hospital discharge which may impact their ability to make effective decisions about their healthcare. However, informal care partners (CPs) may assist in managing HF when provided with appropriate education and support. The goal of this randomized clinical trial (RCT) is to evaluate an intervention which will provide 1) additional teaching on management of HF to the patient and CP following hospital discharge, 2) improved communication with the family physician, 3) a HF decision support tool for oral diuretic management, and 4) a digital talking scale. The investigators believe this intervention will improve outcomes and be cost saving. The investigators hypothesize that enhanced education and support for the CPs to assist older HF patients following hospital discharge, combined with improved communication with family physicians, contact with a HF nurse, and simple decision support tools, will lead to earlier recognition of clinical deterioration, and improved patient outcomes. Innovative and cost-effective approaches to manage HF patients following hospital discharge are urgently needed in Canada.

Enrollment

78 patients

Sex

All

Ages

60+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Primary diagnosis of Heart Failure (with preserved or impaired left ventricular systolic dysfunction) confirmed with the Boston Criteria >= 5 points
  • 60 years of age or older

Exclusion criteria

  • Residence in, or planned discharge to a long-term care facility (LTC)
  • Life expectancy less than 3 months
  • Patient transferred to Geriatric Rehabilitation unit
  • No caregiver
  • Residence is more than a 30 minute rive from hospital of discharge
  • Patient refused to participate
  • Caregiver refused to participate
  • Patient referred for CV surgery prior to hospital discharge
  • Patient on IV Lasix at or bumetamide at hospital discharge
  • Not on PO Lasix at hospital discharge
  • Patient currently on dialysis
  • Caregiver unavailable during daytime hours
  • Caregiver has disability, serious mental illness or cognitive dysfunction
  • Patient discharged early
  • Patient enrolled in another randomized controlled trial
  • Patient expired
  • Patient and caregiver unable to speak and read English (Patient may be enrolled if nurse can converse minimally with patient and caregiver. S-TOFHLA will not be done for reading comprehension and questionnaires will be administered orally.)
  • Severe aortic stenosis or severe mitral stenosis

Trial design

Primary purpose

Supportive Care

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

78 participants in 4 patient groups

Enhanced Caregiver Support with Caregiver
Experimental group
Description:
Standardized Heart Failure Discharge Summary to Primary Care Physicians© Standardized education sessions Heart Failure Diuretic Decision Support Tool for Patient Self Management© Digital talking scale
Treatment:
Other: Heart Failure Diuretic Decision Support Tool for Patient Self Management©
Other: Usual care
Behavioral: Standardized education sessions
Other: Digital talking scale
Other: Standardized Heart Failure Discharge Summary to Primary Care Physicians©
Usual Care with Caregiver
Other group
Description:
Usual care
Treatment:
Other: Usual care
Enhanced Support without Caregiver
Experimental group
Description:
Standardized Heart Failure Discharge Summary to Primary Care Physicians© Standardized education sessions Heart Failure Diuretic Decision Support Tool for Patient Self Management© Digital talking scale
Treatment:
Other: Heart Failure Diuretic Decision Support Tool for Patient Self Management©
Other: Usual care
Behavioral: Standardized education sessions
Other: Digital talking scale
Other: Standardized Heart Failure Discharge Summary to Primary Care Physicians©
Usual Care without Caregiver
Other group
Description:
Usual Care
Treatment:
Other: Usual care

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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