Collaborative Cardiac Care Project

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Collaborative Cardiac Care Project (C3P)

Conditions
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Myocardial Ischemia, Angina Pectoris, Coronary Disease

Intervention / Treatment
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* Procedure: Collaborative care model
* Procedure: Group interventions
* Procedure: Facilitated consultation


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Arm 1<br> | Procedure: Collaborative care model<br> <br> Procedure: Group interventions<br> <br> Procedure: Facilitated consultation<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Marginal cost effectiveness during one-year study period |  |  | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Outcomes Assessment, Primary Health Care, Group Process