Reducing Readmission for Frail Elderly Patients With Decompensated Heart Failure (HFF-ED)

Jewish General Hospital

Status: Completed

Conditions: Emergencies; Fragility; Acute Decompensated Heart Failure; Heart Failure

Treatments: Other: Control Group (Standard Care); Behavioral: Intervention Group

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT03246035

ADHF-ED-JGH

Details and patient eligibility

About

A randomized study designed to determine whether telephone based interventions can prevent return hospital visits for elderly and frail patients with acute symptoms of heart failure. Specifically, the intervention will improve patients ability to monitor and address self care of heart failure at home.

Full description

Acute decompensated heart failure (ADHF) is a common illness in Canadian emergency departments (ED). The frail subset of elderly patients with ADHF is challenging to treat, use a large proportion of available resources, and are at higher risk for complications, including readmission to hospital after discharge. The investigators believe that by improving access to follow-up, optimizing self-care, and addressing the various cognitive and physical limitations of frailty, it will be possible to improve quality of life and reduce readmission rates for frail patients with ADHF.

Enrollment: 60 patients

Sex: All

Ages: 65+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients who presented to the ED and who are being discharged with a primary or secondary diagnosis of ADHF
• Age ≥ 65
• Frailty, defined as a FRAIL score >=3/5 or Clinical Frailty Scale (CFS) score >=5/9
• Informed consent provided by the patient or proxy

Exclusion criteria

• Significant dementia or active delirium
• Severe frailty, defined as a CFS score >=8/9
• Prohibitive language barrier
• Primary address outside of Quebec
• Patient deemed to be palliative or moribund by treating team

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

60 participants in 2 patient groups

Control Group (Standard Care)

Active Comparator group

Description:

The control group will receive outpatient follow-up, medication advice and lifestyle guidance as prescribed at discharge from the ED or hospital.

Treatment:

Other: Control Group (Standard Care)

Intervention Group

Experimental group

Description:

The intervention will consist of contacting the patient 5 days post-discharge and arranging definitive outpatient follow-up and providing targeted medical and lifestyle advice based on deficient domains identified at baseline.

Treatment:

Behavioral: Intervention Group