Trial DesignKnowledge to action: Rationale and design of the Patient-Centered Care Transitions in Heart Failure (PACT-HF) stepped wedge cluster randomized trial
Section snippets
Trial registration and ethics
The trial is registered on clinicaltrials.gov (NCT02112227) and approved by the Research Ethics Boards of participating hospitals and community agencies.
Selection of hospitals
We sent invitations for trial participation to 11 large, tertiary care cardiac centers across southern Ontario. Hospitals that agreed to implementation of the services following a Stepped Wedge design were included. Representatives of 1 hospital could not agree to a randomized sequence of implementation across sites; we excluded this hospital
Discussion
Knowledge Translation (KT) is an iterative process that includes synthesis, dissemination, exchange and application of knowledge to improve health, provide effective health services and products, and strengthen the health care system.[43] The PACT-HF model, informed by a prior comparative effectiveness meta-analysis of transitional care services,13 translates knowledge to action by implementing in real world settings those services that improved clinical outcomes in the tightly-controlled
Acknowledgements
We are indebted to Daniel Ball, Elizabeth Banting, Maria De Leon, Nancy Elford, Jeanine Harrison, Elena Holt, Gail Johnson, Colleen Lackey, Bill Liu, Roberta Napoleoni, Tracey Renton, Donna Richardson, Teresa Smith, Nazneen Solkar, Anne Stephens, and Shannon Tyrrell for their important roles in the PACT-HF trial. This work is dedicated to the memory of Aubrey Ignatius Van Spall, beloved father and friend.
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Bridging Treatment Implementation Gaps in Patients With Heart Failure: JACC Focus Seminar 2/3
2023, Journal of the American College of CardiologyUnderutilization of Guideline-Directed Medical Therapy in Heart Failure: Can Digital Health Technologies PROMPT Change?
2022, Journal of the American College of CardiologyThe Hospital at Home Model vs Routine Hospitalization for Acute Heart Failure: A Survey of Patients’ Preferences
2022, CJC OpenCitation Excerpt :This cross-sectional survey was conducted among hospitalized patients at 2 large academic hospitals in Ontario, Canada (Hamilton General Hospital and Juravinski Hospital) from January, 2016 to March, 2016. This study was conducted as a substudy of the Patient-Centered Care Transitions in Heart Failure (PACT-HF) trial.10,11 The study was approved by the research ethics boards of participating hospitals.
Protection by inclusion: Increasing enrollment of women in cardiovascular trials
2022, American Heart Journal Plus: Cardiology Research and PracticeCare Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure: Rationale and design of CONNECT-HF
2020, American Heart JournalCitation Excerpt :Given limited resources and the possibility of unintended consequences, a rigorous evaluation of these concepts before widespread adoption is paramount. This was apparent in the recently-completed PACT-HF (Patient-Centered Care Transitions in HF) pragmatic, randomized clinical trial, designed to test the effectiveness of a group of HF transitional care services that were based on prior research and guideline recommendations.24,25 Among 2494 patients hospitalized for HF across 10 hospitals in southern Ontario, the intervention did not improve clinical outcomes, including readmission or death.
Registration: clinicaltrials.gov (NCT02112227)