Social Prescribing for Heart Failure

Overseen By Dr. Louise Pilote, MD MPH PhD FRCPC

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: McGill University Health Centre/Research Institute of the McGill University Health Centre

Must be taking: Heart failure medications

Disqualifiers: Severe cognitive impairment, others

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

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether social prescribing can help women with heart failure adhere to their medication and improve their quality of life. Social prescribing connects patients with community services to address challenges like income issues, loneliness, and transportation, which can affect health outcomes. Women with heart failure who face these social challenges might be suitable for this study. Participants will either receive personalized social connections or continue with their standard heart failure care. The goal is to determine if these community connections can improve medication adherence and positively impact daily living. As an unphased trial, this study offers a unique opportunity to explore innovative support methods that could enhance daily life and health management.

Do I need to stop my current medications to join the trial?

The trial does not specify whether you need to stop taking your current medications. It focuses on improving adherence to existing heart failure medications through social support.

What prior data suggests that social prescribing is safe for women with heart failure?

Research has shown that social prescribing (SP) can safely and effectively improve health for people with heart failure. In past studies, SP connected patients to community resources addressing needs like income, housing, and mental health. This approach aims to address social factors that can impact how well patients follow heart failure treatments.

Studies have found that patients in SP programs often have fewer hospital visits and lower death rates compared to those receiving standard care. For example, one study showed a significant drop in hospital visits for patients involved in SP activities.

These findings suggest that SP is generally well-received, with no serious side effects reported in the research. Since this trial is in a "Not Applicable" phase, it likely indicates the treatment is considered low risk, focusing on non-medical support rather than new drugs or medical procedures. Overall, SP appears to be a safe option for addressing the social factors affecting heart failure patients. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about social prescribing for heart failure because it addresses social determinants of health, which are often overlooked in traditional treatments like medications and surgeries. Unlike standard treatments that focus solely on physiological symptoms, social prescribing connects patients with community resources and support networks, which can improve mental well-being and quality of life. This holistic approach aims to tackle the root causes of health disparities, potentially leading to more sustainable, long-term health improvements.

What evidence suggests that social prescribing is effective for improving adherence and quality of life in women with heart failure?

Studies have shown that social factors, such as access to community resources, closely link to hospital visits and deaths in people with heart failure. In this trial, one group of participants will receive social prescribing, which connects patients with these resources to address such factors. Research indicates that patients who used social prescribing in heart failure clinics had much lower rates of returning to the hospital or dying. Specifically, 42% of patients with social prescribing faced these outcomes compared to 65% who received regular care. This approach could help women with heart failure adhere to their medication regimen and improve their quality of life by addressing the social issues affecting their health. ^{1 2 3 6 7}

Are You a Good Fit for This Trial?

This trial is for Canadian women with heart failure who are at high risk of not following their medical treatment plans. They must score two or more points on a social health questionnaire and be willing to potentially receive non-medical support based on their needs.

Inclusion Criteria

Two or more points on the weighted SPARK questionnaire

I am a woman.

I have a valid health ID.

Exclusion Criteria

Patients not meeting inclusion criteria

Not residents of the province where they are being followed or who have opted out from their provincial health registry

I do not take heart failure medications.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Preparation

Preparation phase includes LW selection, training, and listing of community supports and services

6 months

Intervention

Social prescribing intervention where participants receive personalized social prescriptions based on SDOH vulnerabilities

1 year

Monthly follow-up calls

Follow-up

Participants are monitored for adherence to GDMT and quality of life improvements

1 year

What Are the Treatments Tested in This Trial?

Interventions

• Social Prescribing

Trial Overview The study tests if 'Social Prescribing' (SP), which involves personalized referrals to community services, can help these women follow their heart medication schedules better and improve their quality of life compared to standard care without SP.

How Is the Trial Designed?

Group I: Social prescription Experimental Treatment 1 Intervention

The intervention consists of SP, wherein patients identified as having significant SDOH-related vulnerabilities on the SPARK questionnaire or during an interview will have a consultation with a LW who will provide them with social prescriptions.

Group II: Control Active Control 1 Intervention

Usual Care

Who Is Running the Clinical Trial?

McGill University Health Centre/Research Institute of the McGill University Health Centre

Lead Sponsor

Trials

476

Recruited

170,000+

Canadian Institutes of Health Research (CIHR)

Collaborator

Trials

1,417

Recruited

26,550,000+

Published Research Related to This Trial

Patients managed in a heart failure clinic had a significantly lower rate of rehospitalization or death (42%) compared to those receiving usual care (65%) over a follow-up period of about 561 days, indicating better outcomes with specialized management.

Those in the heart failure clinic not only received more optimal pharmacological therapy but also reported a better quality of life, highlighting the benefits of targeted care in managing heart failure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Heart failure clinic in a community hospital improves outcome in heart failure patients. Lainscak, M., Keber, I.[2022]

Citations

1. onlinecjc.ca onlinecjc.ca/article/S0828-282X(24)00016-3/fulltext

Social Determinants of Health, Adherence, and Outcomes ... Several social determinants of health (SDOH) have been strongly associated with both hospitalizations and mortality in heart failure (Fig. 1).

2. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38215972/

Social Determinants of Health, Adherence, and Outcomes ... Social Determinants of Health, Adherence, and Outcomes in Heart Failure: The Role of Social Prescribing. Can J Cardiol. 2024 Jun;40(6):973-975.

3. ctv.veeva.com ctv.veeva.com/study/social-prescribing-to-improve-adherence-and-outcomes-in-women-with-heart-failure

Social Prescribing to Improve Adherence and Outcomes in ... Based on pilot data, the proportion of women followed in heart failure clinics is 28% and the proportion of eligible women (i.e. 1 point or ...

4. withpower.com withpower.com/trial/social-prescribing-for-heart-failure-8f19b

Social Prescribing for Heart Failure · Info for Participants Patients managed in a heart failure clinic had a significantly lower rate of rehospitalization or death (42%) compared to those receiving usual care (65%) over ...

5. ahajournals.org ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.124.012357

Social Determinants of Health and Disparities in Guideline ... Fewer than 20% of eligible patients with heart failure with reduced ejection fraction receive all 4 pillars of guideline-directed medical ...

6. bmcprimcare.biomedcentral.com bmcprimcare.biomedcentral.com/articles/10.1186/s12875-025-02997-6

The dual impact of social prescribing: targeting social ... To evaluate a 12-week social prescribing intervention targeting SDoH for individuals with, or at risk of developing chronic disease on health- ...

7. researchgate.net researchgate.net/publication/377311262_Social_Determinants_of_Health_Adherence_and_Outcomes_in_Heart_Failure_The_Role_of_Social_Prescribing

Social Determinants of Health, Adherence and Outcomes ... It is estimated that around 20% of patients consult their general practitioner (GP) for what is primarily a social problem (Low Commission, 2015).