None listed
Conditions
Brief 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).
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 longe
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.
Sponsors
Baker IDI Heart and Diabetes Institute
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All patients admitted to the Alice Springs Hospital with the admission diagnosis of ST elevation myocardial infarction (STEMI), Non ST segment elevation ACS, or angina. Aged over 18 years Able to provide informed consent Resident of Central Australia
Exclusion criteria
Patients will be excluded if they do not survive to discharge, have a discharge diagnosis inconsistent with ACS, who are not residents of Central Australia (i.e. Interstate or international visitors), or who have a significant neurological/cognitive impairment that prevents informed consent being obtained
Outcome results
None listed