The Heart Failure Readmission Intervention by Variable Early Follow-up (THRIVE) Study

Last updated: June 9, 2023
Sponsor: Kaiser Permanente
Overall Status: Completed

Phase

N/A

Condition

Chest Pain

Congestive Heart Failure

Heart Failure

Treatment

Telephone Call

In-Person Primary Care Clinical Follow-Up Visit

Clinical Study ID

NCT03524534
CN-16-2667
  • Ages > 21
  • All Genders

Study Summary

This study is a pragmatic randomized clinical trial to determine the effectiveness of two strategies of early follow-up in adults after hospitalization for heart failure: telephone follow-up with a heart failure care manager vs. in-person clinic visit with their primary care provider. The primary outcomes during 30-day follow-up will include readmission for heart failure, death and readmission for any cause. The study team aims to randomly assign 2400 patients during a 15-month period in a 1-to-1 ratio to either an initial structured telephone call with a heart failure care manager or an in-person primary care clinic visit within 7 days of discharge. A secondary goal is to increase the rate of any follow-up within 7 days of discharge to greater than 90 percent among all eligible patients.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • All eligible patients hospitalized for confirmed acute heart failure at a KaiserPermanente Northern California medical center

Exclusion

Exclusion Criteria:

  • Planned discharge to a location other than their home. This includes a skilled nursingfacility, nursing home or hospice facility.
  • Planned discharge to home with hospice care.
  • End-stage renal disease treated with chronic peritoneal dialysis or hemodialysis.
  • Death during the index hospitalization.

Study Design

Total Participants: 2091
Treatment Group(s): 2
Primary Treatment: Telephone Call
Phase:
Study Start date:
January 01, 2017
Estimated Completion Date:
December 31, 2018

Study Description

Heart failure (HF) affects >5 million adults nationally and is the leading cause of hospitalization among Medicare beneficiaries. Reducing hospitalization for heart failure (HF) and subsequent readmissions shortly after discharge is a nationally recognized health care delivery system priority. More than 20% of Medicare patients hospitalized for HF are readmitted within 30 days and this rate has not been declining over the past decade despite increasing attention to this problem. The data that will be collected could allow the study team to tailor the post-discharge follow-up program to patient characteristics to further improve the effectiveness of the interventions.