Status:
NOT_YET_RECRUITING
Tailoring Post Discharge - Remote Education and Access for Cardiac Health
Lead Sponsor:
St. Boniface Hospital
Conditions:
Acute Coronary Syndrome
Myocardial Infarction (MI)
Eligibility:
All Genders
18+ years
Phase:
NA
Brief Summary
Heart attacks are one of the top causes of death in Canada, with over 2,100 cases treated each year in Manitoba. Even though hospital care has improved, the period after going home is still risky. Man...
Detailed Description
STUDY AIM To evaluate the feasibility and effectiveness of a digital-based short-term post-discharge care program - providing education alone or with additional support - in reducing 30-day unexpected...
Eligibility Criteria
Inclusion
- \>18 years old, type 1 myocardial infarction27, resident of Manitoba
Exclusion
- Patients unable to consent or fully participate in the study due to:
- Technology barriers
- Lack of digital device, internet access or data
- Discomfort with using technology
- Communication or language barriers preventing participation
- Cognitive or mental health limiting informed consent or participation
- Dementia or cognitive impairment
- Active or severe psychosis or other significant mental health conditions c. Active substance abuse
- High-risk ACS where patients require more frequent or in person visits a. Cardiac:
- i. Coronary
- Unrevascularizedleftmainormultivessellargeepicardialcoronary artery disease (\>2.5mm)
- Coronary artery bypass surgery (CABG) during index hospitalization ii. Arrhythmias
- Cardiac arrest during index event/hospitalization (ventricular tachycardia (VT)/ventricular fibrillation (VF), pulseless electrical activity (PEA)) iii. Cardiomyopathy
- Left ventricular ejection fraction (LVEF) \<35% (most recent EF assessment)
- Cardiogenic shock requiring pressors/inotropes for more than 24 hours
- Requiring intubation/positive pressure ventilation/hi-flow oxygen for more than 24 hours
- Switchedfromintravenous(IV)tooral(PO)loopdiureticwithinlast 48 hours
- Change in PO loop diuretic dose within last 48 homes (home re- start of 80mg or less is allowed)
- B-type natriuretic peptide (BNP) did not reduce by 30% iv. Cardiac Care Unit (CCU)/Intensive Care Unit (ICU) o Any CCU/ICU stay for more than 24 hours b. Medical: i. any condition with prognosis less than 1 year or a high LACE (Length of stay, Acuity of admission, Comorbidities, Emergency department use) score (\>15)28 ii. any medical comorbidity requiring in-person assessment within 2 weeks TPD-REACH PROTOCOL v3 29Aug2025 8 of 17 TPD-REACH: Remote Education and Access for Cardiac Health iii. transition to an alternative living arrangement/compromised independent living iv. need medication adjustment or investigation within 2 weeks c. Social: i. severe financial strain ii. no fixed address or housing instability iii. severe food insecurity iv. significant hearing or vision impairment v. poor health literacy While we aim to promote health equity, patients facing these challenges need more support than this project can offer and should be connected to appropriate services before discharge.
- Non-atherosclerotic causes of ACS (spontaneous coronary artery dissection, stress- induced cardiomyopathy, myocarditis) as the education and treatment is different
- Any additional factor preventing full participation in the study
Key Trial Info
Start Date :
December 1 2025
Trial Type :
INTERVENTIONAL
Allocation :
ESTIMATED
End Date :
April 30 2027
Estimated Enrollment :
300 Patients enrolled
Trial Details
Trial ID
NCT07171580
Start Date
December 1 2025
End Date
April 30 2027
Last Update
September 12 2025
Active Locations (1)
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1
St Boniface Hospital
Winnipeg, Manitoba, Canada, R2H 2A6