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Trial registered on ANZCTR
Registration number
ACTRN12613000332729
Ethics application status
Approved
Date submitted
4/02/2013
Date registered
26/03/2013
Date last updated
9/09/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
Reducing cost and enhancing access to disease management programs after an acute coronary event
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Scientific title
Investigating a new Alternative model of Cardiac rehabilitation for Cost Effective Secondary prevention (ACCES) to increase the utilisation of existing hospital and community cardiac rehabilitation and secondary prevention amongst patients diagnosed with an acute coronary syndrome
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Secondary ID [1]
281890
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nil known
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Universal Trial Number (UTN)
U1111-1139-2255
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Trial acronym
ACCES
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Coronary Syndrome
288290
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Condition category
Condition code
Cardiovascular
288634
288634
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0
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Coronary heart disease
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Physical Medicine / Rehabilitation
288661
288661
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0
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Other physical medicine / rehabilitation
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Public Health
288670
288670
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Alternative model of cardiac rehabilitation (CR) :
Redesign of internal and external referal processes to hospital and community secondary prevention services.
Changes to Royal Perth Hospital (RPH) Cardiac rehabilitation program delivery . One key aspect is the development and implementation of a new patient needs assessment tool (in consultation with ward staff and internal and external cardiac rehab staff). The tool will be used in the ACCESS group before discharge, taking approximately 10 minutes to complete. The tool helps to assess patient learning needs and forms an individualised CR plan. Participatory action research will be utilised as changes to the needs assessment tool and its implementation process are identified. Routine follow up of all Acute coronary syndrome (ACS) patients at 3 months will also be implementedto ACCESS patients.
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Intervention code [1]
286453
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Rehabilitation
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Intervention code [2]
286454
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Prevention
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Intervention code [3]
286455
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Lifestyle
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Comparator / control treatment
RPH ACS patients admitted 1 April 2011- 31 March 2012 compared to RPH ACS patients admitted 1 April 2013- 31 March 2014
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Control group
Historical
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Outcomes
Primary outcome [1]
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Proportion of RPH ACS patients receiving cardiac rehabilitation and secondary prevention inital assessment and individualised plan (recorded in hospital CR database).
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Assessment method [1]
288787
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Timepoint [1]
288787
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at 2 weeks post discharge
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Primary outcome [2]
288788
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Proportion of patients receiving follow up at 3 months post ACS event to assess clinical management plan in place.
Hospital databases and patient self report utlised.
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Assessment method [2]
288788
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Timepoint [2]
288788
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at 3 months post discharge
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Primary outcome [3]
288789
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Cost effectiveness of CR post ACS admission. Hospital and staff costs measured using hospital databases.
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Assessment method [3]
288789
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Timepoint [3]
288789
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12 months
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Secondary outcome [1]
300993
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Number of hospital readmssions from hospital records
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Assessment method [1]
300993
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Timepoint [1]
300993
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12 months
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Secondary outcome [2]
301045
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mortality rates
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Assessment method [2]
301045
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Timepoint [2]
301045
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at 12 months
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Eligibility
Key inclusion criteria
hospital diagnosis of Acute Coronary Syndrome defined by ICD 10 codes 120 and 121
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Nil groups excluded, assessment on individual basis
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/04/2013
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
540
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
531
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Royal Perth Hospital - Perth
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Recruitment postcode(s) [1]
6271
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6000 - Perth
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Funding & Sponsors
Funding source category [1]
286678
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Government body
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Name [1]
286678
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State Health Research Advisory Council
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Address [1]
286678
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Research development unit, Department of health, PO Box 8172, Perth Business Centre, Perth, WA, 6849
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Country [1]
286678
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Australia
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Primary sponsor type
Individual
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Name
Andrew Maiorana
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Address
Royal Perth Hospital, Exercise physiology department Cardiac Transplant, Wellington St, Perth, WA, 6000
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Country
Australia
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Secondary sponsor category [1]
285453
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Individual
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Name [1]
285453
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Julie Smith
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Address [1]
285453
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Cardiac Rehabilitation, Royal Perth Hospital , Wellington St, Perth, WA, 6000
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Country [1]
285453
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288746
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Royal Perth Hospital
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Ethics committee address [1]
288746
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Wellington St, Perth , WA, 6000
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Ethics committee country [1]
288746
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Australia
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Date submitted for ethics approval [1]
288746
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Approval date [1]
288746
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23/10/2012
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Ethics approval number [1]
288746
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Ref: EC 2012/165
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Summary
Brief summary
ACS patients discharged from RPH from 1st April 2011- 31st March 2012 will be compared to those discharged 1st April 2013- 31st March 2014 . The study will compare 2 models of cardiac rehabilitation: traditional cardiac rehabilitation vs a new alternative model implemented in April 2013. The proportion that access cardiac rehabilitation and secondary prevention programs plus cost effectiveness will be compared. Cardiac rehabilitation is defined as having an initial assessment and individualised plan within 2 weeks , education, and follow up at 3 months. Between April 2012 - March 2013 changes to referral processes and RPH cardiac rehabilitation program delivery were implemented using information sought from staff and patient surveys and focus groups. The study will compare readmssion rates and mortality of both ACS cohorts at 12 months after discharge.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
37610
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Dr Andrew Maiorana
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Address
37610
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Royal Perth Hospital, Advanced heart failure and cardiac transplant Service, Wellington St,
Perth, WA, 6000
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Country
37610
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Australia
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Phone
37610
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+61 (0)433567369
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Fax
37610
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Email
37610
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[email protected]
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Contact person for public queries
Name
37611
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Julie Smith
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Address
37611
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Royal Perth Hospital, Wellington St,
Perth, WA, 6000
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Country
37611
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Australia
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Phone
37611
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+61 (0)411137461
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Fax
37611
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Email
37611
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[email protected]
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Contact person for scientific queries
Name
37612
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Andrew Maiorana
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Address
37612
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Royal Perth Hospital, Advanced heart failure and cardiac transplant Service, Wellington St,
Perth, WA, 6000
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Country
37612
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Australia
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Phone
37612
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+61 (0)433567369
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Fax
37612
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Email
37612
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
The Development of a New Cardiac Rehabilitation Needs Assessment Tool (CRNAT) for Individualised Secondary Prevention.
2015
https://dx.doi.org/10.1016/j.hlc.2015.01.001
N.B. These documents automatically identified may not have been verified by the study sponsor.
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