NCT03876600

Brief Summary

START study is a comparison of cost-utility between permanent pacemaker replacement ambulatory care and permanent pacemaker replacement conventional hospitalization care. The hypothesis of the study is that ambulatory care compared to conventional hospitalization, involving a stay of more than 24 hours, would reduce hospitalization and care expenses without loss of quality of care and without increasing the complication rate for patients.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
750

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Apr 2019

Typical duration for not_applicable

Geographic Reach
1 country

14 active sites

Status
unknown

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

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

February 14, 2019

Completed
29 days until next milestone

First Posted

Study publicly available on registry

March 15, 2019

Completed
17 days until next milestone

Study Start

First participant enrolled

April 1, 2019

Completed
3 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 1, 2022

Completed
Last Updated

March 15, 2019

Status Verified

February 1, 2019

Enrollment Period

3 years

First QC Date

February 14, 2019

Last Update Submit

March 12, 2019

Conditions

Keywords

pacemakerreplace for elective wearfrench contextcost-utility analysisprospectivemulticentricrandomized study

Outcome Measures

Primary Outcomes (1)

  • Cost-utility analysis,from the perspective of the society and a time horizon of 6 months,of ambulatory management compared to the intervention in conventional hospitalization of a replacement,for elective wear,permanent pacemakers

    Incremental cost-utility ratio (cost by quality-adjusted life-years, QALY) of outpatient management compared to compared to the intervention in conventional hospitalization (≥1 night) of a replacement, for elective wear, permanent pacemakers. This analysis is from the perspective of the society and a time horizon of 6 months.

    6 month

Secondary Outcomes (4)

  • Assess, the point of view of health insurance and health care institutions with a time horizon of 5 years, the annual and global budgetary impact in € of different diffusion scenarios for ambulatory to replace conventional hospitalization

    on a time horizon of 5 years

  • Evaluate and compare the rate of complications of different management within 6 months after the intervention in both arms.

    on time horizon of 6 months

  • Evaluate the ambulatory failure rate

    during all the study, during 30 months.

  • Evaluate and compare patients satisfaction between intervention and hospital management in both arms

    during hospitalization, during 2 days

Study Arms (2)

conventional hospitalization management.

EXPERIMENTAL

The patients who are randomized to have a conventional hospitalization for the pacemaker replacement have conventional management. In this management patient come to hospital one day before this surgical operation and he is operated next day

Procedure: Replacement of permanent pacemakers for elective wear.

ambulatory management

ACTIVE COMPARATOR

The patients who are randomized to have a ambulatory surgery for the pacemaker replacement have ambulatory management. In the ambulatory hospitalization patients come to hospital and have a surgical operation the same day

Procedure: Replacement of permanent pacemakers for elective wear.

Interventions

START's intervention is a replacement of permanent pacemakers for elective wear, for the both arms the surgical intervention is the same. The surgical procedure is the same in the both arms. The differences are in conventional hospitalization, patient comes to hospital one day before operation and he can go out one day after operation. In ambulatory patient come to hospital operation days and he can got out the same day.

ambulatory managementconventional hospitalization management.

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Man or woman over 18 years old.
  • Replacement of permanent pacemakers for battery elective wear without programmed act in the sensors regardless of pacemaker type, simple, dual or triple chambers and regardless pacemaker label.
  • Patient living less than an hour from a hospital center
  • Patient is able to answer the phone.
  • Patient has an accompaniment the go out night
  • Pacemaker-dependent patient or not regardless of indication of placement of the pacemaker
  • Patient with or without anticoagulant treatment: the anticoagulant treatment is managed by center under these habits.
  • Patient has given this free and informed consent.
  • Patient having insurance in France.

You may not qualify if:

  • Ambulatory Hospitalization is impossible.
  • Patient refuses to participate
  • Patient has hemostasis disorder yielding ambulatory hospitalization impossible.
  • Woman is pregnant, nursing mothers or the patient don't receive an effective contraception.
  • Patient under guardianship, safeguard of justice

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (14)

Lyon University Hospital

Lyon, Bron, 69677, France

Location

Angers University Hospital

Angers, 49933, France

Location

Brest University Hospital

Brest, 29200, France

Location

Dijon University Hospital

Dijon, 21079, France

Location

Grenoble University Hospital

Grenoble, 38000, France

Location

AP-HM

Marseille, 13005, France

Location

Montpellier University Hospital

Montpellier, 34295, France

Location

Nancy University Hospital

Nancy, 54511, France

Location

AP-HP, La Pitié Salpétrière

Paris, 75013, France

Location

Rennes University Hospital

Rennes, 35033, France

Location

Saint-Etienne University Hospital

Saint-Etienne, 42100, France

Location

Strasbourg University Hospital

Strasbourg, France

Location

Toulouse University Hospital

Toulouse, 31059, France

Location

Tours University Hopsital

Tours, 37044, France

Location

Study Officials

  • Vincent Probst

    Nantes University Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 14, 2019

First Posted

March 15, 2019

Study Start

April 1, 2019

Primary Completion

April 1, 2022

Study Completion

April 1, 2022

Last Updated

March 15, 2019

Record last verified: 2019-02

Data Sharing

IPD Sharing
Will not share

Locations