NCT03382613

Brief Summary

The purpose of this study is to evaluate the impact of a hospital quality improvement (QI) program on the use of guideline-recommended oral anticoagulants (OAC) in hospitalized patients with atrial fibrillation (AF) at risk for ischemic stroke. Specifically, the study will determine whether the intervention, compared to Usual Care, will result in a greater increase in the proportion of patients with AF at risk for ischemic stroke who are appropriately treated with OAC.

Trial Health

57
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2,000

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Dec 2017

Geographic Reach
1 country

62 active sites

Status
terminated

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 19, 2017

Completed
7 days until next milestone

First Posted

Study publicly available on registry

December 26, 2017

Completed
3 days until next milestone

Study Start

First participant enrolled

December 29, 2017

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 3, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 3, 2019

Completed
Last Updated

December 26, 2019

Status Verified

December 1, 2019

Enrollment Period

1.9 years

First QC Date

December 19, 2017

Last Update Submit

December 24, 2019

Conditions

Outcome Measures

Primary Outcomes (1)

  • Change in the Percentage of Patients Treated With OAC From Baseline to Final Collection Periods

    The impact of a hospital quality improvement (QI) program on the use of guideline-recommended oral anticoagulants (OAC) in hospitalized patients with atrial fibrillation (AF) at risk for ischemic stroke will be evaluated by measuring change in the percentage of patients treated with OAC, from baseline to Final Collection Periods.

    Baseline up to 20 months

Secondary Outcomes (4)

  • Percentage of Patients Readmitted to the Same Hospital

    Up to 20 months

  • Percentage of Patients who Received OAC by Hospital Characteristics Subgroups

    End of study (Month 20)

  • Effect of Tools Components of the QI Program on the use of OAC

    End of study (Month 20)

  • Effect of Degree of Engagement in the QI Program

    End of study (Month 20)

Study Arms (2)

Quality Improvement (QI) Program

Hospitals assigned to the QI program arm will begin the 4-month Preparatory Phase which is designed to introduce the institutional baseline reporting tools and materials related to performance improvement, and gain insight into their gaps in treatment, followed by 15 month Implementation Phase, which will consist of education, process, and engagement activities that are targeted at the hospital and healthcare provider level and then the Measurement Period at which time hospitals will complete a final survey to document specific interventions that were successfully implemented and perform a final retrospective chart review on selected patients.

Usual Care

Hospitals assigned to the Usual Care arm will not participate in the structured QI program but will continue with their standard hospital practice in treating patients with atrial fibrillation (AF) at risk for ischemic stroke. Hospitals will also complete a final survey and final retrospective chart reviews during the Measurement Period.

Eligibility Criteria

Age40 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Hospitalized patients with atrial fibrillation (AF) at risk for ischemic stroke will be included.

You may qualify if:

  • Inpatient hospitalization
  • Primary or secondary discharge International Classification of Diseases (ICD)-9/10 diagnosis code for AF paroxysmal (I48.0), persistent (I48.1), chronic (I48.2), or unspecified (427.31, I48.91)
  • Proxied Congestive Heart failure (CHA2DS2-VASC) score greater than or equal to (\>=) 2 using ICD-9 diagnosis scoring algorithm developed previously. The scoring algorithm will be expanded to include ICD-10 codes
  • Discharged to home, skilled nursing facility, inpatient rehabilitation, or nursing home

You may not qualify if:

  • Presence of artificial mechanical heart valve by ICD-9/10 diagnosis or procedure code during comorbid identification period or current hospitalization
  • Surgical procedure during hospitalization for open heart surgery, brain, or spine
  • Intravenous heparin given on the day of discharge without warfarin/oral anticoagulant (OAC), antiplatelets, and/or aspirin
  • History of left atrial appendage occlusion, including the Watchman device
  • Any in-hospital (current hospitalization) bleeding identified by ICD-9/10 diagnosis codes

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (62)

Banner Thunderbird

Glendale, Arizona, 85306, United States

Location

Banner Desert Medical Center

Mesa, Arizona, 85202, United States

Location

Banner Baywood Medical Center

Mesa, Arizona, 85206, United States

Location

Banner Heart Hospital

Mesa, Arizona, 85206, United States

Location

Banner University Medical Center

Phoenix, Arizona, 85006, United States

Location

Banner Estrella

Phoenix, Arizona, 85037, United States

Location

Banner Boswell Medical Center

Sun City, Arizona, 85351, United States

Location

Banner Del Webb

Sun City West, Arizona, 85375, United States

Location

Banner University Medical Center - South (BUMC-S)

Tucson, Arizona, 85713, United States

Location

Banner University Medical Center - Tucson (BUMC-T)

Tucson, Arizona, 85724, United States

Location

Banner North Colorado Medical Center

Greeley, Colorado, 80631, United States

Location

Hartford Hospital

Hartford, Connecticut, 06102, United States

Location

The Hospital of Central Connecticut

New Britain, Connecticut, 06050, United States

Location

AMITA Adventist Medical Center Bolingbrook

Bolingbrook, Illinois, 60440, United States

Location

AMITA Alexian Brothers Medical Center

Elk Grove Village, Illinois, 60007, United States

Location

AMITA Adventist Medical Center Hinsdale

Hinsdale, Illinois, 60521, United States

Location

AMITA St. Alexius Medical Center

Hoffman Estates, Illinois, 60169, United States

Location

AMITA Adventist Medical Center La Grange

La Grange, Illinois, 60525, United States

Location

SSM Health Good Samaritan Hospital

Mount Vernon, Illinois, 62864, United States

Location

Ephraim McDowell Regional Medical Center

Danville, Kentucky, 40422, United States

Location

St. Agnes Hospital

Baltimore, Maryland, 21229, United States

Location

Borgess Medical Center

Kalamazoo, Michigan, 49048, United States

Location

Fremont Health Medical Center

Fremont, Nebraska, 68025, United States

Location

Penn Medicine - Princeton Health

Plainsboro, New Jersey, 08536, United States

Location

AtlantiCare

Pomona, New Jersey, 08240, United States

Location

Southside Hospital

Bay Shore, New York, 11706, United States

Location

Our Lady of Lourdes Hospital

Binghamton, New York, 13905, United States

Location

Long Island Jewish Forest Hills

Forest Hills, New York, 11375, United States

Location

Huntington Hospital

Huntington, New York, 11743, United States

Location

North Shore University Hospital

Manhasset, New York, 11030, United States

Location

Long Island Jewish Med Ctr

New Hyde Park, New York, 11040, United States

Location

Lenox Hill Hospital

New York, New York, 10021, United States

Location

Long Island Jewish Valley Stream

Valley Stream, New York, 11580, United States

Location

Samaritan Medical Center

Watertown, New York, 13601, United States

Location

The Jewish Hospital - Mercy

Cincinnati, Ohio, 45236, United States

Location

Mercy Anderson Hospital

Cincinnati, Ohio, 45255, United States

Location

University Hospitals Cleveland Medical Center

Cleveland, Ohio, 44106, United States

Location

Mercy St. Rita's Medical Center

Lima, Ohio, 45801, United States

Location

Mercy Lorain Regional Medical Center

Lorain, Ohio, 44053, United States

Location

Mercy St. Charles Hospital

Oregon, Ohio, 43616, United States

Location

University Hospitals Regional Hospitals

Richmond Heights, Ohio, 44143, United States

Location

Mercy Health St Vincent Medical Center

Toledo, Ohio, 43608, United States

Location

Mercy St. Anne Hospital

Toledo, Ohio, 43623, United States

Location

Oklahoma Health Science Center

Oklahoma City, Oklahoma, 73104, United States

Location

Saint Francis Hospital

Tulsa, Oklahoma, 74136, United States

Location

St. Luke's University Health Network

Allentown, Pennsylvania, 18102, United States

Location

St.Luke's University Health Network - St.Luke's Cardiology Associates

Bethlehem, Pennsylvania, 18015, United States

Location

Geisinger Medical Center

Danville, Pennsylvania, 17822, United States

Location

Geisinger Medical Center

Scranton, Pennsylvania, 18510, United States

Location

Geisinger Wyoming Valley

Wilkes-Barre, Pennsylvania, 18711, United States

Location

AnMed Health

Anderson, South Carolina, 29621, United States

Location

Avera McKennan Hospital

Sioux Falls, South Dakota, 57105, United States

Location

Hendrick Medical Center

Abilene, Texas, 79601, United States

Location

Methodist Dallas Medical Center

Dallas, Texas, 75203, United States

Location

Methodist Charlton Medical Center

Dallas, Texas, 75237, United States

Location

Methodist Mansfield Medical Center

Mansfield, Texas, 76063, United States

Location

Methodist Richardson Medical Center

Richardson, Texas, 75082, United States

Location

Inova Alexandria Hospital

Alexandria, Virginia, 22304, United States

Location

Inova Health Care Services

Falls Church, Virginia, 22042, United States

Location

Riverside Regional Medical Center

Newport News, Virginia, 23601, United States

Location

St Marys Medical Center

Huntington, West Virginia, 25702, United States

Location

Monongalia County General Hospital Company

Morgantown, West Virginia, 26505, United States

Location

MeSH Terms

Conditions

Atrial Fibrillation

Condition Hierarchy (Ancestors)

Arrhythmias, CardiacHeart DiseasesCardiovascular DiseasesPathologic ProcessesPathological Conditions, Signs and Symptoms

Study Officials

  • Janssen Scientific Affairs, LLC Clinical Trial

    Janssen Scientific Affairs, LLC

    STUDY DIRECTOR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

December 19, 2017

First Posted

December 26, 2017

Study Start

December 29, 2017

Primary Completion

December 3, 2019

Study Completion

December 3, 2019

Last Updated

December 26, 2019

Record last verified: 2019-12

Locations