This is a non-CTIMP randomised controlled trial looking at the utilisation of telemedicine devices to provide remote, clinically necessary, diagnostic information, without the need for hospital attendance that patients will take home with them following admission to hospital with a heart attack.
Following hospital admission with a heart attack, telemedicine equipment can provide patients with remote, clinically necessary diagnostic information without the need for hospital attendance, which they can take home when they discharge from the hospital. In this project, patients known to be at high risk of ACS are equipped and empowered to seek urgent medical attention without visiting the hospital, if they experience symptoms, and to determine whether or not to seek emergency treatment, with an immediate remote specialist consultation, as assessed by validated technology. Those enrolled in the intervention group will be offered telemedicine packages upon discharge from the hospital. Those enrolled in the active arm will have their telemedicine package provided to the trial team when they conduct an ECG and seek medical attention. In contrast, in the control group, routine clinical care will be provided, as well as follow up by phone over 9 months.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
337
Patient develops possible cardiac symptoms, takes an ECG, BP and oxygen saturation as per their training. Patient will receive a phone call by the trial cardiologist who will have access to a high-quality ECG trace, as well as blood pressure and oxygen saturations, and coupled with the clinical history, can decide on the most appropriate course of further management. With remote follow up over the phone at 3, 6 and 9 months.
Standard routine clinical care will be carried out, with remote follow up over the phone at 3, 6 and 9 months.
Imperial College Healthcare NHS Trust
London, United Kingdom
All hospital readmission rates
At 6 months of follow up, compare formal admissions and not emergency room visits in intervention to control groups.
Time frame: 6 months
Length of stay
Length of stay at 3, 6, and 9 months will be compared in both study groups.
Time frame: 9 months
All-cause mortality, morbidity, and MACE.
At 9 months of follow up, compare all-cause mortality, morbidity, and MACE.
Time frame: 9 months
Medical intervention
Compare Medical intervention for for acute coronary syndromes or heart failure, including coronary angiography/ angioplasty, injectable therapy or oxygen therapy for both study groups when readmission to hospital.
Time frame: 9 months
Emergency Department visits
Any emergency department visits not requiring admission or further intervention will be compared in both study groups at 9 months of follow up.
Time frame: 9 months
9 months readmission rates
The readmission rates for 9 months will be compared in both study groups.
Time frame: 9 months
Patient-reported quality of life
Patients in both study groups will fill out a quality of life questionnaires
Time frame: 9 months
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