Clinical trial NCT04507529: Peer-mentor Support for Older Vulnerable Myocardial Infarction Patients
Official title: 'HjertensGlad'.Inequality in Cardiac Rehabilitation Attendance: Peer-mentors as a Feasible Solution
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Myocardial Infarction
Lead sponsor: University College Copenhagen
Sponsor class: OTHER
Collaborators: name: Velux Fonden
name: Danish Nurses Organisation
name: Nordsjællands Hospital
First posted: 2020-08-11
Enrollment: 20
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: OTHER

Brief summary: BACKGROUND: Advanced treatment regimens have reduced cardiovascular mortality resulting in an increasingly older myocardial infarction (MI) population in need of cardiac rehabilitation (CR) , the majority (74%) is above 60 years. The positive effect of CR is well established; CR reduces cardiovascular mortality, lowers hospital admissions, and improves quality of life among patients with ischemic heart disease. These positive effects of CR has also been established among older patients. The inherent problem lies in the low attendance rate, often below 50%. Several studies, including studies from Denmark, have shown that low participation in CR is most prevalent among older, vulnerable female patients. The notion vulnerable covers patients with low socioeconomic position (SEP), patients with non-western background and patients living alone, as these groups have particularly low CR attendance. Effective interventions aiming at increasing CR attendance among these low attending groups are thus warranted and the current study will seek to address this.

AIM: To test feasibility and acceptability of methods used in a peer-mentor intervention among older female and vulnerable post MI patients.

DESIGN AND METHODS: The study is designed as a one arm feasibility study. Patients (n=20) are recruited by a dedicated research nurse before discharge from the cardiology department at Nordsjællands Hospital. Data is collected at three timepoints, baseline, 12 weeks and 24 weeks. The patients (mentees) are matched with peer-mentors. Peer-mentoring (i.e. mentoring by a person with a similar life situation or health problem as one self) is a low-cost intervention that holds the potential to improve CR attendance and improve physical and psychological outcomes among older patients. Peer-mentors are role models who can guide and support patients overcoming barriers of CR attendance. Peer-mentoring is unexplored in a CR setting among older, female and vulnerable MI patients; establishing the novelty of the current study.


Eligibility criteria: Inclusion Criteria:

* ≥65 years and diagnosed with MI and referred to CR and female or low SEP or single living or non-western background.

Exclusion Criteria:

* Patients unable to provide written consent.

Primary outcomes:
measure: Recruitment
timeFrame: Baseline
measure: Dropout
timeFrame: 24 weeks
measure: Satisfaction with intervention
timeFrame: 12 weeks
measure: Number of contacts
timeFrame: 24 weeks
measure: Content of contacts
timeFrame: 24 weeks
measure: CR attendance
timeFrame: 12 weeks
measure: CR attendance
timeFrame: 24 weeks
measure: Change in Health-related Quality of Life
timeFrame: Baseline to 24 weeks
measure: Change in Self-efficacy
timeFrame: Baseline to 24 weeks
measure: Change in symptoms of anxiety and depression
timeFrame: Baseline to 24 weeks
measure: Change in dietary quality
timeFrame: Baseline to 24 weeks
measure: Change in physical activity
timeFrame: Baseline to 24 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Frederikssund
country: Denmark
facility: Nordsjællands Hospital - Frederikssund
city: Hillerød
country: Denmark
facility: Nordsjællands Hospital - Hillerød
Study officials:
affiliation: University College Copenhagen
name: Maria K Pedersen, Ph.d.
role: PRINCIPAL_INVESTIGATOR
References:
citation: Pedersen M, Bennich B, Boateng T, Beck AM, Sibilitz K, Andersen I, Overgaard D. Peer-mentor support for older vulnerable myocardial infarction patients referred to cardiac rehabilitation: single-arm feasibility study. Pilot Feasibility Stud. 2022 Aug 9;8(1):172. doi: 10.1186/s40814-022-01141-w.