Implementing the Addressing Symptoms with Person-Centered Treatment (ADAPT) Program in Heart Failure Care
Investigating Virtual Care for Heart Failure Patients
Lyndsay DeGroot
Primary Investigator
Brief description of study
The purpose of this study is to see if ADAPT, an evidence-based, virtual care program for people living with heart failure, is easy to implement in a regular clinic setting. We also want to see if ADAPT improves quality of life for people with heart failure
Detailed description of study
ADAPT is a virtual care program, and patient research interactions will be happening remotely (via phone or secure teleconferencing). The team delivering ADAPT will be located at a remote, private setting to ensure patient confidentiality. Patients will be encouraged to be in a private setting for meetings as well. The research team anticipates that most patients will take the calls from their home, but it is possible they may be elsewhere during the ADAPT session. Patient-reported outcomes will be collected at baseline and post-intervention defined as within 14 days of the participant’s final session (~ 4 months). Measures will include Measures will include quality of life (FACT-G)22, depression (PHQ-9)23, anxiety (GAD-7)24, disease-specific disease status (KCCQ)25 and palliative care needs (Integrated Palliative Outcome Scale – IPOS)26. All surveys have been shown to be reliable and valid in adults with chronic illness. To assess the feasibility of measuring clinical outcomes from routinely collected electronic health record data, the time to first hospitalization or ED visit and total number of HF-related and all-cause hospitalizations and ED visits will be collected at 3, 6, and 12 months from baseline
Eligibility of study
You may be eligible for this study if you meet the following criteria:
- Conditions: Chronic heart failture
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Age: 40 years - 100 years
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Gender: All
Inclusion Criteria
• Age: ≥ 40
• Diagnosis of Chronic Heart Failure: Documented via ICD-10 codes (I50.2x, I50.3x, I50.4x, I50.8x, I50.9) in the electronic health record.
• High Risk for Hospitalization or Mortality - must meet at least one of the following:
o 1 unplanned hospitalization in the last 1 year with heart failure as primary or secondary admitting diagnosis
o LVEF 3.8cm or LVH)
o Historical BNP > 100 or NT-proBNP > 500
o Currently prescribed ≥ 20mg furosemide (or equivalent) daily
• FACT-G score ≤ 70 and patient-reported presence of fatigue, dyspnea, pain, depression, anxiety, or insomnia
• Documented IU Health primary care provider and cardiologist
• Consistent access to a telephone
Exclusion Criteria
• Cognitive Impairment: Documented ICD-10 diagnosis of Dementia or Major Neurocognitive Disorder (e.g., Alzheimer’s, Vascular, or Frontotemporal dementia) indicated by ICD-10 G30x, F01-F03 or documentation of diagnosis in electronic health record by physician
• Active Substance Use: Documentation of active substance dependence or treatment for substance/alcohol abuse within the previous 6 months (excludes THC/Marijuana or nicotine).
• Metastatic Cancer: Active metastatic (Stage IV) cancer or patients currently undergoing active systemic chemotherapy.
• LVAD/Transplant: Presence of a Left Ventricular Assist Device (LVAD) or currently being evaluated for LVAD or heart transplant
• Current Hospice or Specialty Palliative Care: Currently receiving hospice services or palliative care services (defined as having a palliative care consultation in the previous 3 months).
• Currently incarcerated
• Currently pregnant
• Residing in a skilled nursing facility
This study investigates the ADAPT program, a virtual care initiative for people with heart failure. The purpose of this study is to see if ADAPT, an evidence-based program, is easy to implement in a regular clinic setting and if it improves the quality of life for people with heart failure. Heart failure is a condition where the heart doesn't pump blood as well as it should. The study will look at how well the program works in real-world settings.
Participants in the study will engage with the ADAPT program remotely, using phone or secure video calls. The research team will collect information from patients before and after the program, which lasts around four months. This information includes surveys about quality of life, depression, anxiety, and other health-related questions. They will also track hospital visits to see if the program helps reduce them.
- Who can participate: Adults aged 40 and older with chronic heart failure may participate. Eligibility requires a history of high risk for hospitalization or mortality and consistent access to a telephone. Participants must have specific health conditions or treatments documented by medical codes.
- Study details: Participants will have remote sessions with the research team and complete surveys about their health and quality of life. The study will also track hospital visits to see if the program makes a difference.
Interested in the study?
This study is accepting only persons who receive care at a certain clinic or doctor or who are part of an invited group. Questions about this study can be directed to the study team listed in the description or contact your doctor to see if you are eligible.
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