Social Services Support for Heart Failure

Recruiting at 2 trial locations

Overseen By Stacy Farr, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Saint Luke's Health System

Disqualifiers: Under 18, Over 99

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 2 years

320 Participants Needed

Trial Summary

What is the purpose of this trial?

The objective of this program is to improve post-acute care coordination for necessary social services for patients leaving the hospital after recovering from an episode of decompensated heart failure.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Managed Services, IT Managed Services, Outsourced IT Services, IT Service Management, IT Operations Management, IT Service Delivery for heart failure?

Research shows that disease management programs, which include coordinated care and patient education, improve outcomes for heart failure patients by reducing hospital admissions and mortality. Additionally, nurse-led follow-up care has been found to lower the risk of death in heart failure patients. ^{1 2 3 4 5}

How is the Managed Services treatment for heart failure different from other treatments?

The Managed Services treatment for heart failure is unique because it involves providing social services support, which focuses on managing care through specialized services rather than traditional medical interventions. This approach aims to reduce hospital readmissions and improve patient outcomes by coordinating care and support in the community. ^{6 7 8 9 10}

Eligibility Criteria

This trial is for Missouri or Kansas residents aged 18-99 who are currently hospitalized due to acute heart failure. It's not open to those under 18 or over 99.

Inclusion Criteria

I am currently hospitalized for sudden heart failure.

I am between 18 and 99 years old.

Resident of Missouri or Kansas

Exclusion Criteria

I am between 18 and 99 years old.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either standard medical care or managed services after discharge, including in-home assessment and care coordination

2 years

Follow-up

Participants are monitored for safety and effectiveness after treatment

2 years

Treatment Details

Interventions

• Managed Services

Trial Overview The study is testing a program designed to improve the coordination of social services after patients with heart failure leave the hospital, aiming to reduce rehospitalization rates.

Participant Groups

Group I: Managed Services After Discharge Experimental Treatment 1 Intervention

Subjects receive in-home assessment and care coordination/connection with community resources after hospital discharge

Group II: Standard Of Care - No Managed Services Active Control 1 Intervention

Subjects receive standard medical care and follow-up after hospital discharge

Who Is Running the Clinical Trial?

Saint Luke's Health System

Lead Sponsor

Trials

42

Recruited

12,600+

Truman Medical Center

Collaborator

Trials

10

Recruited

301,000+

University of Missouri, Kansas City

Collaborator

Trials

73

Recruited

34,600+

Mid America Regional Council

Collaborator

Trials

1

Recruited

320+

Findings from Research

Effective disease management programs for heart failure can significantly improve patient outcomes by focusing on coordinated care, patient education, and monitoring, which helps keep patients out of the hospital and reduces mortality.

The main challenges in implementing these programs are changing physician practices and ensuring patient compliance, highlighting the need to effectively utilize existing technologies rather than just developing new ones.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Heart failure and disease management. Leider, HL.[2019]

In a randomized controlled trial involving heart failure patients, a reciprocal peer support program did not show any significant improvement in rehospitalization rates or quality of life compared to standard nurse care management, despite the program's design to enhance patient engagement.

Only 55% of participants in the peer support program actively engaged in the intended peer communication, suggesting that low participation may have contributed to the lack of observed benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomized controlled effectiveness trial of reciprocal peer support in heart failure. Heisler, M., Halasyamani, L., Cowen, ME., et al.[2022]

The implementation of an outpatient inotropic infusion unit and case management at a community hospital led to a significant reduction in hospital admissions and inpatient length of stay for patients with congestive heart failure.

Alongside decreased healthcare costs, patient satisfaction and functional status improved, demonstrating the effectiveness of the new care model.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Heart failure management. Warner, PM., Hutchinson, C.[2019]

A systematic review of 12 studies found that adherence to heart failure performance measures, particularly the use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and beta-blockers at discharge, is strongly associated with improved patient outcomes.

While discharge instructions also positively impacted outcomes, their effect was weaker compared to medication adherence, highlighting the importance of specific treatment measures in managing heart failure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evidence-based heart failure performance measures and clinical outcomes: a systematic review. Maeda, JL.[2018]

Nurse-led follow-up care for heart failure patients after hospital discharge significantly lowers the risk of mortality, highlighting the importance of ongoing support in managing this condition.

This review of case management interventions indicates that structured follow-up by nurses can improve patient outcomes and potentially enhance the quality of care for heart failure patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Nurse support is most effective follow-up for heart failure patients. [2019]

Chronic heart failure poses a significant public health challenge due to its poor prognosis and high rates of hospital readmissions, leading to substantial healthcare costs.

Establishing a specialized service for heart failure patients can address these issues by providing targeted care and potentially improving patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Chronic heart failure: New challenges and new perspectives]. Tereshchenko, SN., Zhirov, IV.[2018]

There is an urgent need for a National Service Framework specifically designed for heart failure, indicating a gap in current healthcare provisions.

Implementing such a framework could improve the management and treatment of heart failure, potentially leading to better patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multidisciplinary interventions in heart failure. Clark, AL., Cleland, JG.[2018]

Hospital-initiated case management (CM) for heart failure patients significantly reduces unplanned readmissions by 26% and decreases the length of hospital stay by an average of 1.28 days compared to usual care, based on a systematic review of 22 studies involving over 8,600 participants.

Community-initiated CM showed limited effectiveness, with only non-randomized trials indicating a reduction in admissions, suggesting that hospital-based interventions may be more beneficial for managing heart failure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does case management for patients with heart failure based in the community reduce unplanned hospital admissions? A systematic review and meta-analysis. Huntley, AL., Johnson, R., King, A., et al.[2021]

The establishment of an Integrated Heart Failure Service (IHFS) at a district general hospital led to a significant increase in the quality of care for heart failure patients, including higher rates of cardiologist consultations and echocardiography, as well as improved initiation of essential heart failure medications.

Patients with heart failure with preserved ejection fraction (HFpEF) experienced a notable reduction in 30-day post-discharge mortality and readmission rates, highlighting the effectiveness of the IHFS in improving outcomes for this specific group.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The impact of an integrated heart failure service in a medium-sized district general hospital. Hawley, A., He, J., Crabtree, A., et al.[2020]

A nurse-led service was established in the UK to manage chronic heart failure, addressing the needs of 880,000 individuals affected by this condition.

The initiative is part of a national priority to improve heart failure management, highlighting the importance of specialized care in enhancing patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating the effect of setting up a nurse-led heart failure service. Ayers, N.[2007]

References

1. United States pubmed.ncbi.nlm.nih.gov

Heart failure and disease management. [2019]

2. United States pubmed.ncbi.nlm.nih.gov

Randomized controlled effectiveness trial of reciprocal peer support in heart failure. [2022]

3. United States pubmed.ncbi.nlm.nih.gov

Heart failure management. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Evidence-based heart failure performance measures and clinical outcomes: a systematic review. [2018]

5. England pubmed.ncbi.nlm.nih.gov

Nurse support is most effective follow-up for heart failure patients. [2019]

6. Russia (Federation) pubmed.ncbi.nlm.nih.gov

[Chronic heart failure: New challenges and new perspectives]. [2018]

7. England pubmed.ncbi.nlm.nih.gov

Multidisciplinary interventions in heart failure. [2018]

8. England pubmed.ncbi.nlm.nih.gov

Does case management for patients with heart failure based in the community reduce unplanned hospital admissions? A systematic review and meta-analysis. [2021]

9. England pubmed.ncbi.nlm.nih.gov

The impact of an integrated heart failure service in a medium-sized district general hospital. [2020]

10. England pubmed.ncbi.nlm.nih.gov

Evaluating the effect of setting up a nurse-led heart failure service. [2007]