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Optimising Management of Patients With Heart Failure With Preserved Ejection Fraction in Primary Care (OPTIMISEHFpEF)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT03617848
Recruitment Status : Active, not recruiting
First Posted : August 7, 2018
Last Update Posted : January 7, 2020
Sponsor:
Collaborators:
University of Oxford
Keele University
University of Manchester
Information provided by (Responsible Party):
Professor Christi Deaton, Cambridge University Hospitals NHS Foundation Trust

Brief Summary:
Heart failure (HF) accounts for 2% of National Health Service (NHS) expenditure, and 5% of emergency hospitalisations. Patients with HF with preserved ejection fraction (HFpEF) are older, have more comorbidities, have similarly poor or worse outcomes compared to patients with reduced ejection fraction (HFrEF), and currently lack an evidence base for treatment. The investigators hypothesise that outcomes of patients with HFpEF can be improved through optimised management and self-management of comorbidities, fluid status and lifestyle delivered in primary care in collaboration with specialists. The primary aim is to develop a programme of optimised management by improving understanding of needs and experiences of patients with HFpEF, clinical decision-making and management in primary care, and integrating research findings with patient and clinical expertise. The main objective for this work package is to identify patients with HFpEF in primary care and assess comorbidities and other factors, management, morbidity and mortality at one year. The methodology employed will be a longitudinal cohort study of 270 patients with HFpEF in primary care followed for 12 months.

Condition or disease
Heart Failure With Preserved Ejection Fraction

Detailed Description:
This work package of the study will use phenotyping and one-year follow-up of a community recruited cohort of patients with HFpEF or probable HFpEF to understand the characteristics and needs of this patient group. It involves a longitudinal cohort study conducted to identify patients with HFpEF in primary care and assess comorbidities, lifestyle factors, frailty, self-management, symptoms, quality of life, cognitive function, types of care received, management of risk factors and comorbidities, and one year morbidity and mortality. This will inform particular areas for assessment and management/self-management in the optimised programme. The investigators will also apply to NHS Digital who are the data controllers of Hospital Episode Statistics to check if participants have had any hospitals visits throughout the duration of the study.

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Study Type : Observational
Actual Enrollment : 153 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Optimising Management of Patients With Heart Failure With Preserved Ejection Fraction in Primary Care
Actual Study Start Date : July 17, 2018
Estimated Primary Completion Date : June 2020
Estimated Study Completion Date : June 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Failure

Group/Cohort
Cohort
A cohort of participants with suspected stable HFpEF will be recruited from the primary care setting. HFpEF diagnosis will be confirmed as per the 2016 European Society of Cardiology (ESC) guidelines for diagnosing HFpEF. All participants will undergo a series of assessments including but not limited to pulse wave velocity, 6 minute walk test, blood tests including natriuretic peptides (NT-Pro-BNP), ECG, physical assessments and a series of questionnaires. Those with confirmed HFpEF will be followed up at 6 and 12 months.



Primary Outcome Measures :
  1. Morbidity [ Time Frame: 1 year from recruitment ]
    Episodes of diseases

  2. Mortality [ Time Frame: 1 year from recruitment ]
    Confirmed death during follow-up


Secondary Outcome Measures :
  1. Kansas City Cardiomyopathy Questionnaire [ Time Frame: Baseline, 6 & 12 months ]
    Heart failure specific quality of life over time (transformed total score 0 - 100); higher scores indicate better quality of life. 5 point change considered clinically relevant.

  2. 6 Minute Walk Test [ Time Frame: baseline to 6 & 12 months ]
    physical function changes over time

  3. Montreal Cognitive Assessment (MOCA) [ Time Frame: baseline to 6 & 12 months ]
    cognitive function over time


Biospecimen Retention:   Samples Without DNA
Serum and plasma will be retained for future analysis as novel biomarkers emerge


Information from the National Library of Medicine

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Ages Eligible for Study:   16 Years and older   (Child, Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Adult males and females with suspected Heart Failure with Preserved Ejection fraction
Criteria

Inclusion Criteria:

Adult patients with diagnosed or suspected HFpEF (defined as: patients diagnosed with non-valvular HF that are i) not diagnosed with left ventricular systolic dysfunction or have a documented ejection fraction < 50%; or ii) do have a reported 'normal' or preserved EF, documented EF > 50%, or reported diastolic dysfunction without moderate to severe systolic dysfunction) who:

  • Have stable Class I - III New York Heart Association (NYHA) classification for chronic heart failure
  • Have not been hospitalised for an exacerbation of their heart failure in the 6 weeks prior to screening
  • Are able to communicate in English (both verbally and in writing)

Exclusion Criteria:

Any patients who have:

  • Any severe neuro-psychological or neuro-cognitive conditions that would confound outcome assessment
  • NYHA Class IV classification for chronic heart failure receiving end of life care, or other life-threatening condition

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03617848


Locations
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United Kingdom
Cambridge University Hospital NHS Foundation Trust
Cambridge, United Kingdom
Sponsors and Collaborators
Professor Christi Deaton
University of Oxford
Keele University
University of Manchester
Investigators
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Principal Investigator: Christi Deaton, PhD,RN Cambridge University Hospitals NHS FT

Additional Information:
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Responsible Party: Professor Christi Deaton, Cambridge University Hospitals NHS Foundation Trust
ClinicalTrials.gov Identifier: NCT03617848    
Other Study ID Numbers: 234872
First Posted: August 7, 2018    Key Record Dates
Last Update Posted: January 7, 2020
Last Verified: January 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Professor Christi Deaton, Cambridge University Hospitals NHS Foundation Trust:
HFpEF
Additional relevant MeSH terms:
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Heart Failure
Heart Diseases
Cardiovascular Diseases