Risk-guided Disease Management in Coronary Artery Disease
Australia101 participantsStarted 2021-07-17
Plain-language summary
Coronary artery disease (CAD) is the number one killer of Australians with a high risk for a recurrent event(s) and hospital readmission. Many of these readmissions can be prevented with better management to control the problem of CAD. A disease management program, led by nurses who interact with other health professionals/providers, can help with education and counselling, taking medications correctly and making healthy lifestyle changes for higher risk patients. Newer models of disease management programs make use of mobile devices (such as an "app") and telehealth (by phone or video call) to monitor and manage health which could facilitate CAD management. Therefore, the aim of this study is to test this type of disease management program (DMP) compared to standard care for reducing hospital readmissions or death in people with CAD who are at high risk of being readmitted. The Investigators envisage that a novel Risk-Guided DMP will be favorable to patients and associated with high-level participation. The Investigators hypothesize that high-risk patients randomized to Risk-Guided CAD will have reduced hospital readmissions or death compared with those randomized to usual care.
Who can participate
Age range
30 Years – 74 Years
Sex
ALL
See this in plain English?
AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion criteria
. Aged between 30 to 74 years; AND
. Hospitalised with CAD or other eligible cardiac procedure or condition including acute myocardial infarction (STEMI or NSTEMI), unstable angina, coronary artery bypass grafting or percutaneous coronary intervention; AND
. Defined as higher risk (score \>= 5) by PEGASUS-TIMI 54 criteria; AND
. Eligible for Medicare.
Exclusion criteria
. Inability to provide written informed consent; OR
. Non-English speaking; OR
Questions worth asking your doctor
Bring these to your next appointment. They're a starting point for a shared conversation — not a sign you qualify or a recommendation to enrol.
1Since this trial is already completed and was measuring hospitalizations and deaths in people with coronary artery disease, has my doctor seen any published results, and do those results suggest that risk-guided nurse management might be something worth considering in my own care plan?
2This study focused on nurses playing a central role in managing coronary artery disease — what would that kind of nurse-led, risk-guided approach actually look like for me day-to-day, and is it something available outside of this trial at our clinic?
3Because the trial tracked serious outcomes like hospitalization and death, what does my doctor think my current personal risk level is, and how is my care already being tailored to that risk?
4Since this trial is now completed rather than still enrolling, are there any follow-up studies or similar programs I could potentially be considered for that use a comparable risk-based management strategy for coronary artery disease?
5Given that this was a non-drug, care-management type of study, would my doctor recommend I pursue any changes to how my coronary artery disease is being monitored and managed right now, based on what trials like this have shown about the value of structured follow-up?
Generated to help you prepare — always confirm anything about your own eligibility and care with the study team and your doctor.
Questions for the trial coordinator
The trial coordinator is the person who runs the study day to day. These cover the practical side — logistics, costs, and what taking part would actually mean for your life. The study team confirms whether you meet the criteria; these are questions to ask, not a sign you qualify.
1What does taking part actually involve week to week — how many visits, where, and how long does each one take?
2What costs are covered by the study, and what might I have to pay for myself, including travel, parking, or time off work?
3What happens during screening, and what happens if the study team confirms I don't meet the criteria after those tests?
4Who pays for the scans, blood work, and other tests the trial requires — the study, my insurance, or me?
5How will being in the trial affect my regular care, and will my own doctor stay informed and involved?
6Can I leave the trial at any point if I change my mind, and what would happen to my care if I do?
A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.