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CompletedNCT03402750Updated Nov 7, 2019Results posted

Heart Failure Medication Adherence

An interventional study of Meds to Beds and Electronic Prescription in Heart Failure, sponsored by University of Miami. Completed at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2019-11-07.

Sponsored by University of Miami · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
40
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The objective of this investigation is to pilot test a medication in-hand intervention (Meds to Beds) compared to standard care for patients with heart failure (ICD-50[all numbers]). The study will evaluate if the intervention improves adherence and physical health, and reduces hospital re-admissions. The study will provide evidence for the feasibility and acceptability of the medication-in-hand intervention.

02

Conditions studied

  • Heart Failure

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Keywords

  • Adherence, Medication, Prescription
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Admission diagnosis of heart failure ICD-50, including I50.1, I50.2, I50.20, I50.21, I50.22, I50.23, I50.3, I50.30, I50.31, I50.32, I50.33, I50.4, I50.40, I50.41, I50.42, I50.43, I50.8, I50.81, I50.810, I50.811, I50.812, I50.813, I50.814, I50.82, I50.83, I50.84, I50.89, I50.9, or any combination thereof
  • Age 18 or older
  • New York Heart Association Heart Failure Class II or Class III, with ejection fraction below 45%
  • Cognitively intact, without significant psychological impairment affecting medication adherence such as dementia noted in patient record.

Exclusion criteria

Exclusion Criteria:

  • Medical conditions, such as active cancer or pregnancy, expected to alter heart failure medication management
  • Discharged to nursing homes or hospice care, where patient may not responsible for their own adherence
  • High risk of loss to follow-up, e.g., leaving the hospital against medical advice, prisoners, living in a homeless shelter, or unable to provide a phone number
  • No plan to fill medications at the Jackson Memorial Hospital pharmacy
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
40 participants (actual)

Study arms

  • Experimental
    Meds to Beds

    Patients receive medication in-hand at discharge from the hospital

    Behavioral: Meds to Beds

  • Active comparator
    Standard Care

    Electronic prescription with patient pickup at the pharmacy

    Behavioral: Electronic Prescription

Interventions

  • BehavioralMeds to Beds

    Medications will be delivered to patient bedside before discharge

  • BehavioralElectronic Prescription

    Patient or surrogate can pick up medication from pharmacy

05

What researchers measure

Primary outcomes

  1. Adherence to Medication

    Adherence to medication will be reported as the number of participants that scores 12 and lower in a self-reported Adherence to Refills and Medications Scale (ARMS) Questionnaire. The questionnaire has 12 items with each item being recorded on a four-point Likert scale. The total score ranges from 12-48 with the lower score indicating better adherence.

    Time frame: Day 30

  2. Pharmacy Refill Adherence to Medication

    Medication adherence will be reported as the number of participants that completed their expected pharmacy refill. Standard Care participants are expected to complete one initial fill and one refill. Meds to Beds participants are expected to complete one pharmacy refill as the initial fill is handed upon discharge.

    Time frame: Day 30

Secondary outcomes

  1. Physical Health as Assessed by the Patient-Reported Outcome Measurement Information System (PROMIS) Questionnaire

    Physical health is measured using the 10 item PROMIS questionnaire. Responses are recorded along a 5-point Likert scale with a total score ranging from 10-50. A higher score indicates better physical health.

    Time frame: Baseline and Day 30

  2. Number of Participants That Received Their Medications Prior to Discharge.

    The program's feasibility will be evaluated by tracking whether medications can be successfully delivered (i.e., before discharge) to patients in the Meds to Beds condition. This measure will be evaluated as a proportion within the intervention condition.

    Time frame: Day 0

  3. Intervention Acceptance

    All participants will be asked one question about the acceptability of the intervention program. Responses for acceptability items will be recorded on a 10-point scale (1, very unsatisfactory - 10, very satisfactory). Dichotomized due to extreme skew. Intervention acceptance will be reported as the number of participants that provides a score of 1 and higher.

    Time frame: Day 30

06

Results

Posted Nov 7, 2019

Participant flow

Participant flow — Overall Study
MilestoneMeds to BedsStandard Care
Started2020
Completed1819
Not completed21
Withdrew: Lost to follow-up21

Outcome measures

PrimaryAdherence to Medication

Adherence to medication will be reported as the number of participants that scores 12 and lower in a self-reported Adherence to Refills and Medications Scale (ARMS) Questionnaire. The questionnaire has 12 items with each item being recorded on a four-point Likert scale. The total score ranges from 12-48 with the lower score indicating better adherence.

Time frame:
Day 30
Reported as:
Count of participants · Participants
Adherence to Medication
ParticipantsMeds to BedsStandard Care
Adherence to Medication23
PrimaryPharmacy Refill Adherence to Medication

Medication adherence will be reported as the number of participants that completed their expected pharmacy refill. Standard Care participants are expected to complete one initial fill and one refill. Meds to Beds participants are expected to complete one pharmacy refill as the initial fill is handed upon discharge.

Time frame:
Day 30
Reported as:
Count of participants · Participants
Pharmacy Refill Adherence to Medication
ParticipantsMeds to BedsStandard Care
Pharmacy Refill Adherence to Medication76
SecondaryPhysical Health as Assessed by the Patient-Reported Outcome Measurement Information System (PROMIS) Questionnaire

Physical health is measured using the 10 item PROMIS questionnaire. Responses are recorded along a 5-point Likert scale with a total score ranging from 10-50. A higher score indicates better physical health.

Time frame:
Baseline and Day 30
Reported as:
Mean · score on a scale
Physical Health as Assessed by the Patient-Reported Outcome Measurement Information System (PROMIS) Questionnaire
score on a scaleMeds to BedsStandard Care
30-Day follow-up11.81 ± 4.0911.50 ± 3.90
Baseline/Discharge8.56 ± 3.1610.19 ± 3.51
SecondaryNumber of Participants That Received Their Medications Prior to Discharge.

The program's feasibility will be evaluated by tracking whether medications can be successfully delivered (i.e., before discharge) to patients in the Meds to Beds condition. This measure will be evaluated as a proportion within the intervention condition.

Time frame:
Day 0
Reported as:
Count of participants · Participants
Number of Participants That Received Their Medications Prior to Discharge.
ParticipantsMeds to BedsStandard Care
Number of Participants That Received Their Medications Prior to Discharge.75
SecondaryIntervention Acceptance

All participants will be asked one question about the acceptability of the intervention program. Responses for acceptability items will be recorded on a 10-point scale (1, very unsatisfactory - 10, very satisfactory). Dichotomized due to extreme skew. Intervention acceptance will be reported as the number of participants that provides a score of 1 and higher.

Time frame:
Day 30
Reported as:
Count of participants · Participants
Intervention Acceptance
ParticipantsMeds to BedsStandard Care
Intervention Acceptance109

Adverse events

Collected over 30 days. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Meds to Beds1/20 (5%)1/20 (5%)0/20 (0%)
Standard Care1/20 (5%)1/20 (5%)0/20 (0%)
Most frequent serious events
Most frequent serious events
EventMeds to BedsStandard Care
DeathCardiac disorders1/201/20

Baseline characteristics

Age, Continuous
Age, Continuous(years)Meds to BedsStandard CareTotal
Mean57.85 ± 6.5458.55 ± 11.1858.20 ± 8.86
Sex: Female, Male
Sex: Female, Male(Participants)Meds to BedsStandard CareTotal
Female235
Male181735
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Meds to BedsStandard CareTotal
Ethnicity — Hispanic111223
Ethnicity — African American7815
Ethnicity — White202
07

Study locations

1 site
  • Jackson Memorial Hospital
    Miami, Florida 33136, United States
08

References and documents

Study documents

  • Study protocol · Jul 19, 2018
  • Statistical analysis plan · Jul 19, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03402750
Lead sponsor
University of Miami
Collaborators
Beta Tau Chapter of Sigma Theta Tau International
Responsible party
Brian McCabe (Research Associate Professor, University of Miami) — Principal investigator
First posted
Jan 18, 2018
Start date
May 28, 2018
Primary completion
Apr 8, 2019
Completion
Apr 8, 2019
Results posted
Nov 7, 2019
Last update
Nov 7, 2019

Study contacts

Brian E McCabe, PhD
principal investigator · University of Miami

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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