RecruitingACTRN12614000284662

The Central Australian Heart Protection Study: A Randomised Trial of Nurse-Led, Family Based Secondary Prevention of Acute Coronary Syndromes.

Sponsor

Baker IDI Heart and Diabetes Institute

Enrollment

360 participants

Start Date

Dec 1, 2011

Study Type

Interventional

Conditions

Acute Coronary Syndromes

Summary

Despite the high burden of cardiovascular diseases among Indigenous Australians, few intervention trials have sought to evaluate novel approaches to reducing differential outcomes in this vulnerable group. The Central Australian Heart Protection Study seeks to test the effectiveness of a nurse-led, family based education and assessment program in reducing the incidence of poor outcomes in indigenous and non-indigenous patient’s following an Acute Coronary Syndrome (ACS).

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Plain Language Summary

Simplified for easier understanding

This study is testing whether a nurse-led, family-based education and support program reduces poor health outcomes in patients (including Indigenous Australians) who have been admitted to Alice Springs Hospital following a heart attack or chest pain event (Acute Coronary Syndrome). The program focuses on heart health education and ongoing monitoring to help people stay well after discharge. You may be eligible if: - You are 18 years of age or older - You have been admitted to Alice Springs Hospital with a heart attack, unstable angina, or related diagnosis - You are a resident of Central Australia - You are able to give informed consent You may NOT be eligible if: - You did not survive to discharge from hospital - Your final diagnosis was not consistent with a heart-related event - You are visiting from interstate or overseas (not a local resident) - You have a serious cognitive impairment that prevents consent Talk to your doctor about whether this trial might be right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

The aim of this study is to test the effectiveness of a culturally appropriate, integrated family based secondary prevention (SP) program in reducing the incidence of major adverse coronary events (MACE) in indigenous and non-indigenous patient’s discharged from Alice Springs Hospital following an Acute Coronary Syndrome ACS. Key features of the study intervention will include: 1. A 90minute comprehensive, home-based assessment of factors likely to positively or negatively impact on the longer-term CV health of the patient within 14 days of hospital discharge. This assessment will occur at baseline, and protocol driven management and education will be delivered by individual case-managers focused on medical therapy, cardiac education and awareness, symptom recognition, necessary follow up and guideline based stepped care to target. 2. A computerised decision support system incorporating all clinical and demographic data relative to local evidence-based guidelines (CARPA Standard Treatment Manual) will be used to guide individual case management, delivered by outreach nurses at baseline, 6 months, 12 months with final close out visit at 24 months. Visits last for approximately 1 hour. Individual follow up may vary according to predefined risk, clinical stability and the achievement of secondary prevention targets in blood pressure, lipid levels and psychosocial status (depression scores). Those individuals at elevated risk or clinically unstable will be visited at weekly to three monthly intervals (in addition to standard visit follow up) until clinically stable. 3. Repeated application of the decision support tool over twelve months of active nurse-led stepped care, to identify key therapeutic targets and treatments necessary to achieve them for optimal risk reduction (secondary prevention) in patients with ACS. 4. A family-based clinical and education intervention will also applied by a trained cardiac nurse and Aboriginal Health Worker (AHW) tailored to the patient’s health assessment (as specified above). This will occur once at the first home visit, and last approximately 30-60 minutes.