Clinical trial NCT03143881: Assessment Of Educational Strategies In Heart Failure Patients Presenting To The Emergency Department For Care
Official title: Assessment Of Patient Knowledge And Effects Of Educational Strategies In Un- And Under-Insured Heart Failure Patients Presenting To The Emergency Department For Care
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Heart Failure
Lead sponsor: Baylor College of Medicine
Sponsor class: OTHER
First posted: 2017-05-08
Enrollment: 94
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study evaluates the impact of a new education-based intervention on outcomes in un- and under-insured Heart Failure (HF) patients presenting to the Emergency Department (ED) for care. Intervention patients will receive personalized education regarding their condition, pre- and post-testing of their HF knowledge base, and ED standard of care during the enrollment (index) visit. Patients will then be contacted via telephone 30 days post-index visit for re-testing and reinforcement of previously learned material. Patients in the control group will receive ED standard of care.

Detailed description: In 2015, 12.8% of adults ages 19-64 in the United States lacked any form of health insurance. An even greater number fell under the umbrella of under-insured. Studies indicate that the un- and under-insured receive less preventive care, are diagnosed at more advanced disease stages, and have higher mortality rates than their insured counterparts, due to the lack of accessible primary care services. These issues are most readily evident in patients with chronic conditions. When a preventable, chronic condition worsens, these patients have no choice but to visit the ED to address their most immediate health concerns, leaving the underlying chronic problem untreated. HF is a particularly burdensome chronic problem for patients of all socioeconomic statuses and one of the leading causes of ED and hospital readmissions.

Numerous educational efforts have been tested in an attempt to reduce HF readmissions but have met with mixed results. Consequently, HF patients are generally seen as refractory to educational and management strategies. The investigators propose here a new, targeted educational intervention designed to improve patient outcomes and readmission rates in un- and underinsured HF patients.

Eligibility criteria: Inclusion Criteria:

* Patients with a pre-existing documented diagnosis of HF presenting to the ED

Exclusion Criteria:

* 1) Patients in unstable condition requiring immediate medical attention, 2) hemodynamically unstable, 3) age \< 18 years, and/or 4) incarcerated.

Primary outcomes:
measure: Change in ED revisits
timeFrame: 30 and 90 days
measure: Change in hospital readmissions
timeFrame: 30 and 90 days
Secondary outcomes:
measure: Days alive and out of hospital (DAOH)
timeFrame: 365 days (1 year)
Other outcomes:
Locations:
Study officials:
affiliation: Baylor College of Medicine
name: Vishwaratn Asthana
role: PRINCIPAL_INVESTIGATOR
affiliation: Baylor College of Medicine
name: William Peacock
role: PRINCIPAL_INVESTIGATOR
References: