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CompletedNCT04902768APPROACH-IS IIUpdated May 16, 2024

Assessment of Patterns of Patient Reported Outcomes in Adults With Congenital Heart Disease - International Study II

An observational study in Congenital Heart Disease, sponsored by KU Leuven. Completed at 53 sites in 32 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-05-16.

Sponsored by KU Leuven · Observational

Study type
Observational
Model
Case-only
Time perspective
Cross-sectional
Enrollment
8,415
Ages
18 Years and older
Sex
All
01

Study summary

This is an international, cross-sectional and descriptive study that aims to investigate differences in patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) and that aims to explore the profile and healthcare needs of adults with congenital heart diseases.

Read the detailed description

The research aims of this study are:

  1. To further explore differences in a modified selection of patient-reported outcome measures (PROMs) and (as a new addition in APPROACH-IS II) explore differences in patient-reported experience measures (PREMs), by enrolling adults with congenital heart diseases in low, middle, and high income countries and including new potential explanatory variables ("Part 1").
  2. To explore the profile and healthcare needs of a subgroup of older adults with congenital heart disease, with a particular focus on investigating the frailty phenotype ("Part 2").
02

Conditions studied

  • Congenital Heart Disease

Keywords

  • Congenital Heart Disease
  • Quality of life
  • Patient reported outcomes
  • Patient reported experience measures
  • Geriatric phenotype
03

In context

Heart Defects, Congenital

991 studies on the registry are indexed under Heart Defects, Congenital; 251 are open to participants now.

This study's enrollment of 8,415 is above the median of 119 across 440 observational studies indexed under Heart Defects, Congenital.

Browse Heart Defects, Congenital studies →

Lead sponsor

KU Leuven is the lead sponsor of 373 studies on the registry; 65 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Probability sample

Study population

Adults with congenital heart disease who are in follow-up at an adult congenital heart disease center or included in a national/regional registry.

For Part 1 of this study, each participating center will aim to recruit 200 adult patients with CHD aged 18 years or older with simple, moderate, or complex congenital heart disease. For Part 2 of this study, within these samples of 200 patients, centers will aim to recruit about 20 adults aged 40-50y, 20 adults aged 50-60y and 20 adults aged >60 years who are diagnosed with moderate to great disease complexity.

Depending on the data collection method, sampling is at random or consecutive. Both a probability and convenience sample can be used.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Diagnosed with congenital heart disease, defined as: "a gross structural abnormality of the heart and/or intra-thoracic great vessels that is actually or potentially of functional significance (including mild, moderate, and complex heart defects)"
  • Aged 18 years of age or older at the moment of study inclusion
  • Diagnosed with congenital heart disease before the age of 10 years
  • Follow-up at an ACHD center or included in a national/regional registry
  • Physical, cognitive, and language abilities to complete self-report questionnaires

Exclusion criteria

Exclusion Criteria:

  • Prior heart transplantation
05

Study design

Observational model
Case-only
Time perspective
Cross-sectional
Enrollment
8,415 participants (actual)
Patient registry
No

Groups and cohorts

  • Adults with congenital heart disease

    Other: This is an observational study, there is no intervention

Interventions

  • OtherThis is an observational study, there is no intervention

    This is an observational study, there is no intervention. Hence, this is not applicable.

06

What researchers measure

Primary outcomes

  1. Patient-reported health status

    This outcome is measured using the shortened version of the RAND-36. Composite physical (PCS) and mental health (MCS) scores are computed. Scores range from 0 (lowest health level) to 100 (highest health level).

    Time frame: Baseline

  2. Patient-reported health status

    This outcome is measured using the Linear Analogue Scale Health Status (LAS HS). Scores range from 0 (worst imaginable health state) to 100 (best imaginable health state).

    Time frame: Baseline

  3. Patient-reported depressive symptoms

    This outcomes is measured using the Patient Health Questionnaire 8. Scores range from 0 to 24. Scores of ≥10 indicate depression.

    Time frame: Baseline

  4. Patient-reported anxiety symptoms

    This outcome is measured using the General Anxiety Disorder 7. Scores range from 0 to 21. Scores of 5, 10, and 15 are taken as cut-off points for mild, moderate and severe anxiety.

    Time frame: Baseline

  5. Patient-reported quality of life

    This outcome is measured using the Linear Analog Scale on Quality of Life (LAS QOL). Scores range from 0 (worst imaginable quality of life) to 100 (best imaginable quality of life).

    Time frame: Baseline

  6. Patients' perception of providers' autonomy support

    This outcome is measured using the modified Health Care Climate Questionnaire (mHCCQ). Each of the 6 items is scored from 1 to 7. Scores are calculated by averaging the individual item scores. Higher average score represents a higher level of perceived autonomy support.

    Time frame: Baseline

  7. Cognitive functioning

    This outcome is measured using the Montreal Cognitive Assessment Screener (MoCA). Scores range from 0 to 30. Scores of \<26 indicate cognitive dysfunction.

    Time frame: Baseline

  8. Frailty phenotype

    This outcome is classified using the Fried method (i.e., non-frail (no positive criterion), pre-frail (1 or 2 criteria positive), or frail (when ≥3 criteria are positive).

    Time frame: Baseline

Secondary outcomes

  1. Patient-reported stigma

    This outcome is measured using the Chronic Illness Stigma Scale (CISS). Scores range from 8 to 40. Higher scores indicating higher levels of perceived stigma.

    Time frame: Baseline

  2. Patient-reported illness identity

    This outcome is measured using the Illness Identity Questionnaire (IIQ). The questionnaire consists of a five-item rejection scale, seven-item enrichment scale, five-item acceptance scale and eight-item engulfment scale. A mean score is calculated per subscale. Higher scores indicate more rejection, enrichment, acceptance or engulfment.

    Time frame: Baseline

  3. Patient-reported empowerment

    This outcome is measured using the Gothenburg Empowerment Scale (GES generic v1.1). Scores range from 15 to 75. Higher score reflects a higher level of empowerment.

    Time frame: Baseline

  4. Patient-reported healthcare utilization

    This outcomes was measured using the Patient-Reported Inpatient and outpatient Utilization Survey (PRIUS). Higher numbers indicate more healthcare use.

    Time frame: Baseline

  5. Patient-reported functional status

    This outcome is classified according to the New York Heart Association (NYHA).

    Time frame: Baseline

  6. Patient-reported social support

    This outcomes is measured using the Multidimensional Scale on Perceived Social Support Scale (MSPSS). Scores range from 12 to 84. Higher score indicates greater social support perceived by an individual.

    Time frame: Baseline

  7. Patient-reported parental involvement

    This outcome is measured using an adapted version of the subscale on parents of the Multidimensional Scale on Perceived Social Support. Scores range from 5 to 35. Higher score indicates greater parental support in childhood and adolescence.

    Time frame: Baseline

  8. Advance care planning

    This outcome is measured using a survey developed for APPROACH-IS II by the Steering Committee, based on previous research. A sample question is 'Have you personally written down information about the care you would want in case you become seriously ill in the future?'.

    Time frame: Baseline

  9. Patient-reported social media to connect with peers

    This outcome is measured using a survey developed for APPROACH-IS II by the Steering Committee, based on previous research. A sample question is 'How would you describe your experiences connecting with other people with CHD through social media?'.

    Time frame: Baseline

  10. Presence and burden of comorbidities

    This outcome is measured using the Charlson Comorbidity Index.

    Time frame: Baseline

  11. Patient-reported socio-demographic variables (eg. age, educational level)

    Self-reported

    Time frame: Baseline

  12. Medical variables by chart review (eg. diagnosis, cardiac surgeries)

    This outcome is classified according to the adult congenital heart disease anatomic and physiological (ACHD AP) classification system of Stout and colleagues.

    Time frame: Baseline

07

Study locations

53 sites
  • University of California
    San Francisco, California 92093-0021, United States
  • Lucile Packard Children's Hospital and Stanford Health Care
    Stanford, California 94304, United States
  • University of Florida Health
    Gainesville, Florida 32611, United States
  • Taussig Heart Center of Johns Hopkins Hospital
    Baltimore, Maryland 21287, United States
  • Boston Children's / Brigham and Women's
    Boston, Massachusetts 02115, United States
  • Mount Sinai Heart
    New York, New York 10029, United States
  • Nationwide Children's Hospital
    Columbus, Ohio 43205, United States
  • Oregon Health and Science University
    Portland, Oregon 97239, United States
  • Philadelphia Penn Medicine
    Philadelphia, Pennsylvania 19104, United States
  • University of Southwestern Medical Center
    Dallas, Texas 75390, United States
  • Hospital San Juan De Dios De La Plata
    Buenos Aires, Argentina
  • Hospital de Niños
    Córdoba, Argentina
  • Melbourne Children's Cardiology
    Melbourne, Australia
  • Vienna General Hospital
    Vienna, Austria
  • Ghent University Hospital
    Ghent, Belgium
  • University Hospitals Leuven
    Leuven, Belgium
  • Princess Marina Hospital
    Gaborone, Botswana
  • Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto
    Ribeirão Preto, Brazil
  • National Heart Hospital
    Sofia, Bulgaria
  • Clinique Medical Le Jourdain
    Yaoundé, Cameroon
  • Mazankowski Alberta Heart Institute
    Edmonton, Canada
  • Montreal Heart Institute, Université de Montréal
    Montréal, Canada
  • Intituto Nacional Del Torax
    Santiago, Chile
  • Meintegral Clinic
    Manizales, Colombia
  • Copenhagen University Hospital
    Copenhagen, Denmark
  • College of Health sciences, Addis Ababa University
    Addis Ababa, Ethiopia
  • Hôpital cardiologique Haut-Leveque
    Bordeaux, France
  • Montpellier University Hospital
    Montpellier, France
  • Hôpital Européen Georges Pompidou
    Paris, France
  • AHEPA University Hospital
    Thessaloníki, Greece
  • Amrita Institute of Medical Sciences
    Kochi, India
  • Policlinico San Donato (IRCCS)
    Milan, Italy
  • Chiba Cerebral and Cardiovascular Center
    Chiba, Japan
  • Samsung Medical Center
    Seoul, Korea, Republic of
  • Paediatric & Congenital Heart Centre, IJN (National Heart Institute)
    Kuala Lumpur, Malaysia
  • Mater Dei Hospital
    Imsida, Malta
  • Centrum voor Congenital Hartafwijkingen
    Groningen, Netherlands
  • Oslo University Hospital, Rikshospitalet
    Oslo, Norway
  • Aga Khan University Hospital
    Karachi, Pakistan
  • Reference Center of Congenital Heart Disease , University Hospital Center of São João
    Porto, Portugal
  • Centre Hospitalier Régional de Thiès
    Thiès, Senegal
  • Sahlgrenska University Hospital
    Gothenburg, Sweden
  • Skånes Universitetssjukhus
    Lund, Sweden
  • Karolinska Universitetssjukhuset
    Stockholm, Sweden
  • Umea University Hospital
    Umeå, Sweden
  • Uppsala University Hospital
    Uppsala, Sweden
  • University Hospital Bern
    Bern, Switzerland
  • Hôpitaux Universitaires de Genève
    Genève, Switzerland
  • Centre Hospitalier universitaire vaudois
    Lausanne, Switzerland
  • National Taiwan University Hospital
    Taipei City, Taiwan
  • Ege University Health Application and Research Center, Cardiology Department
    Bornova, Turkey
  • Royal Brompton Hospital, Royal Brompton & Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust
    London, United Kingdom
  • Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust
    Newcastle, United Kingdom
08

References and documents

Publications

  • Moons P, Goossens E, Luyckx K, Kovacs AH, Andresen B, Moon JR, Van De Bruaene A, Rassart J, Van Bulck L; APPROACH-IS II consortium and ISACHD. The COVID-19 pandemic as experienced by adults with congenital heart disease from Belgium, Norway, and South Korea: impact on life domains, patient-reported outcomes, and experiences with care. Eur J Cardiovasc Nurs. 2022 Aug 29;21(6):620-629. doi: 10.1093/eurjcn/zvab120. PubMed 34927192 ↗

Individual participant data

Plan to share: No — Well-argued and reasonable requests can be directed to the Principal Investigator (Prof. Philip Moons) of the study.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Aug 2019 to primary completion in Aug 2022, 36 months.

How these figures are worked out, and which studies are left out of them.

Registered
May 20, 2021
First posted
May 26, 2021
StartActual
Aug 1, 2019
Primary completionActual
Aug 31, 2022
CompletionActual
Dec 31, 2022
Last update
May 16, 2024
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 16, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04902768
Lead sponsor
KU Leuven
Responsible party
Philip Moons (Prof. Dr. Philip Moons, KU Leuven) — Principal investigator
First posted
May 26, 2021
Start date
Aug 1, 2019
Primary completion
Aug 31, 2022
Completion
Dec 31, 2022
Last update
May 16, 2024

Study contacts

Philip Moons, PhD, RN
principal investigator · Professor in Healthcare Sciences

Oversight

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

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This study is completed, as verified in May 2024. You cannot join it, but the record below documents what was studied.

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