About this trial
In Ghana, about 88.3 per cent of cardiac admissions are due to Heart failure, making it the leading cause of admission due to heart conditions. Despite improved knowledge on heart failure and an increasing array of evidence-based guideline treatment options, there is still a significant readmission rate worldwide. This may be due to the underutilization of these evidence-based therapies or a lack of proper follow-up on these patients. Recurrent hospital admission is an independent predictor of death in heart failure. Strategies aimed at providing increased support at discharge and effective follow-up may be associated with lower readmission risk. This study aims to assess the effect of extensive post-discharge counselling and effective phone-based follow-up on the 30-day and 90-day heart failure readmission rate at a tertiary hospital in Ghana. This is a single-centre, pilot randomised controlled trial of heart failure patients admitted to the Komfo Anokye Teaching Hospital
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
· Adults Aged 18 years and above
Diagnosed with heart failure
NYHA Class II-IV
Informed consent
Disqualifiers
· NHYA class I
Patients who do not have access to a mobile phone
Trial design
Parallel
Treatments tested in this trial
Extensive post discharge counselling and phone-based follow up
Other interventionCounselling by their attending physicians plus Extensive post-discharge counselling from a study doctor/pharmacist/a trained nurse and telephone follow-ups in addition to their normal outpatient reviews. The telephone follow-ups will be weekly for the first 30 days and then 4 weekly till day 90.
Treatment groups
Trial outcomes
Primary outcomes
the occurrence of heart failure-related hospital readmission within 30 days and within 90 days after discharge from the index hospitalization
the occurrence of heart failure-related hospital readmission within 30 days and within 90 days after discharge from the index hospitalization
Secondary outcomes
1. Readmission rate of heart failure patients on guideline-directed heart failure medications
The readmission rate of heart failure patients on guideline-directed medical therapy (GDMT) will be compared to those who are not on GDMT.
Quality of life of the heart failure patients at 90 days
Quality of life at 90 days will be measured using the Kansas City Cardiomyopathy Questionnaire (KCCQ).
All-cause mortality within 30 and 90 days
. Assessing all-cause mortality will involve tracking total deaths from any reason within a population over the 90-day follow-up
Caregiver burden in heart failure management
Caregiver burden will be assessed using the standard tool "Caregiver Burden Questionnaire - Heart Failure Version 3.0 (CBQ-HF)
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