Clinical Trial: Cardiac Home Education and Support Trial (CHEST): A Pilot Study

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: A Pilot Trial of a Home-Based Peer Support Program After Coronary Artery Bypass Graft Surgery

Brief Summary:

Coronary artery bypass graft (CABG) surgery is performed more frequently on individuals who are older and sicker than in previous years. Increased patient acuity and reduced hospital length of stays leave individuals ill prepared for their recovery following discharge. Individuals experience pain, functional impairment and depressive symptoms following discharge, which persist for 8 weeks in 50% of individuals. Unrelieved pain, functional decline and depressive symptoms predispose individuals to adverse events, impaired health-related quality of life (HRQOL), and increased morbidity and mortality.

Existing supports; including printed education materials, community care resources, cardiac rehabilitation programs and nurse-initiated telephone follow-up, fail to address concerns of individuals in this early period following hospital discharge.

Despite the positive health outcomes in other patient populations, valid studies examining the impact of telephone-based peer support to men and women after hospital discharge from CABG surgery were not found. It is anticipated that a home-based peer support program, delivered by telephone, will improve recovery and enhance HRQOL for individuals in the early weeks post hospital discharge from CABG surgery.


Detailed Summary:

Coronary artery bypass graft (CABG) surgery is performed more frequently on individuals who are older and sicker than in previous years. This, combined with reduced hospital length of stays, leaves individuals ill prepared for their recovery after discharge. Individuals experience pain, functional impairment and depressive symptoms; which predispose them to adverse events and impaired health-related quality of life (HRQOL). A home-based peer support program may improve recovery outcomes for individuals following CABG surgery.

The objectives of this pilot trial were to test the feasibility of all procedures, specifically to determine: 1) an estimate of patient and peer recruitment rates, 2) peer compliance and dose of the intervention, 3) peer satisfaction with orientation, 4) peer support activities offered to patients, and 5) patients' satisfaction with peer support. Additionally, exploratory research questions were used to determine indicators of the effects of peer support on HRQOL, pain, pain-related interference with activities, function, depressive symptoms, and enrolment in cardiac rehabilitation. An 8-week pre-post test RCT design enrolled men and women undergoing CABG surgery at a single site in Southeastern Ontario. Patients were randomized to either a usual care or an intervention group. Patients allocated to usual care received preoperative/postoperative education sessions, a preoperative video/information booklet, and preoperative/postoperative visits from in-hospital peer volunteers. In addition to usual care, patients in the intervention group received individualized education and support via telephone for 8 weeks following hospital discharge from trained peer volunteers.

Peer volunteers participated in a 4-hour orientation session. Ninety-three percent of the peers felt adequately prepared for their peer vo
Sponsor: University of Toronto

Current Primary Outcome: Health-Related Quality of Life (SF-36v2-Acute Form) [ Time Frame: 9 weeks ]

Original Primary Outcome: Health-Related Quality of Life (SF-36v2-Acute Form)

Current Secondary Outcome:

  • Pain (McGill Pain Questionnaire-Short Form) [ Time Frame: 9 weeks ]
  • Interference With Activities (Brief Pain Inventory-Interference Subscale) [ Time Frame: 9 weeks ]
  • Function (Human Activity Profile) [ Time Frame: 9 weeks ]
  • Depressive Symptoms (Center for Epidemiologic Studies Depression Scale) [ Time Frame: 9 weeks ]


Original Secondary Outcome:

  • * Pain (McGill Pain Questionnaire-Short Form)
  • * Interference with Activities (Brief Pain Inventory-Interference Subscale)
  • * Function (Human Activity Profile)
  • * Depressive Symptoms (Center for Epidemiologic Studies Depression Scale)


Information By: University of Toronto

Dates:
Date Received: January 10, 2006
Date Started: February 2006
Date Completion:
Last Updated: June 5, 2009
Last Verified: April 2009