Collaborative Cardiac Care Project - Full Text View

Purpose

Data from VA-funded studies and the broader literature indicate that chronic stable angina (CSA) is prevalent, under recognized, under treated and associated with reduced quality of life. There are substantial opportunities for improving care of patients with this debilitating and potentially fatal problem. Because primary care providers manage most patients with CSA, efforts to improve care must necessarily involve the primary care delivery system. C3P is composed of a set of interventions employing a Collaborative Care Team model, which has been shown to be effective in managing other chronic illnesses in the primary care setting.

Condition	Intervention
Myocardial Ischemia Angina Pectoris Coronary Disease	Procedure: Collaborative care model Procedure: Group interventions Procedure: Facilitated consultation


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Collaborative Cardiac Care Project (C3P)

Further study details as provided by VA Office of Research and Development:

Primary Outcome Measures:

Symptom control, quality of life and satisfaction at one year; improved practitioner compliance with national clinical practice guidelines over the one-year intervention period

Secondary Outcome Measures:

Marginal cost effectiveness during one-year study period


Enrollment:	287
Study Start Date:	October 2004
Study Completion Date:	July 2007

Arms	Assigned Interventions
Arm 1	Procedure: Collaborative care model Procedure: Group interventions Procedure: Facilitated consultation

Detailed Description:

Objectives of the proposed project are to: 1) ascertain whether a collaborative approach to managing CSA in primary care results in better symptom control and quality of life than routine care; 2) assess whether the practice of providers assigned to the intervention group is more consistent with national clinical practice guidelines than that of control providers; 3) assess satisfaction of both patients and providers with this approach to management; and 4) assess marginal cost-effectiveness.

Eligibility


Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Providers:

Staff (MD, PA, NP) or resident (R1, R2)
at least 1 participating patient

Patients

assigned to participating provider
diagnosis consistent with IHD
2 visits in past year
frequent angina symptoms (SAQ freq. score less than 70)

Exclusion Criteria:

Providers:

- No participating patients

Patients:

cognitive impairment (inability to complete questionnaires and phone interviews)
non-participating provider
life expectancy of less than 24 months

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00105664

Locations


United States, California
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, California, United States, 94304-1290
United States, Colorado
VA Eastern Colorado Health Care System, Denver, CO
Denver, Colorado, United States, 80220
United States, Oregon
VA Portland Health Care System, Portland, OR
Portland, Oregon, United States, 97239
United States, Washington
VA Puget Sound Health Care System Seattle Division, Seattle, WA
Seattle, Washington, United States, 98108

Sponsors and Collaborators

VA Office of Research and Development

Investigators


Principal Investigator:	Stephan D. Fihn, MD MPH	VA Puget Sound Health Care System Seattle Division, Seattle, WA

More Information

Publications:

Wang L, Porter B, Maynard C, Bryson C, Sun H, Lowy E, McDonell M, Frisbee K, Nielson C, Fihn SD. Predicting risk of hospitalization or death among patients with heart failure in the veterans health administration. Am J Cardiol. 2012 Nov 1;110(9):1342-9. doi: 10.1016/j.amjcard.2012.06.038. Epub 2012 Jul 21.

Fihn SD, Bucher JB, McDonell M, Diehr P, Rumsfeld JS, Doak M, Dougherty C, Gerrity M, Heidenreich P, Larsen G, Lee PI, Lucas L, McBryde C, Nelson K, Plomondon ME, Stadius M, Bryson C. Collaborative care intervention for stable ischemic heart disease. Arch Intern Med. 2011 Sep 12;171(16):1471-9. doi: 10.1001/archinternmed.2011.372.

Fan VS, Bridevaux PO, McDonell MB, Fihn SD, Besser LM, Au DH. Regional variation in health status among chronic obstructive pulmonary disease patients. Respiration. 2011;81(1):9-17. doi: 10.1159/000320115. Epub 2010 Aug 17.


Responsible Party:	VA Office of Research and Development
ClinicalTrials.gov Identifier:	NCT00105664 History of Changes
Other Study ID Numbers:	IHI 02-062
Study First Received:	March 16, 2005
Last Updated:	April 6, 2015

Keywords provided by VA Office of Research and Development:


Outcomes Assessment Primary Health Care Group Process

Additional relevant MeSH terms:


Ischemia Coronary Disease Coronary Artery Disease Myocardial Ischemia Angina Pectoris Pathologic Processes Heart Diseases Cardiovascular Diseases	Vascular Diseases Arteriosclerosis Arterial Occlusive Diseases Chest Pain Pain Neurologic Manifestations Nervous System Diseases Signs and Symptoms

ClinicalTrials.gov processed this record on July 26, 2017

Collaborative Cardiac Care Project (C3P)