June 22, 2020
Study investigates the importance of patient engagement
A team of researchers within the University of Calgary’s Cumming School of Medicine is investigating how patient feedback can be better used to improve care for people with cardiovascular disease.
Co-leading the IMPROVE CV Care trial is the Libin Cardiovascular Institute’s Dr. Steve Wilton, MD, a cardiologist and a patient outcomes researcher who co-leads the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH), one of the largest cardiovascular databases in North America.
“Understanding patients’ descriptions of their symptoms and quality of life is a really important part of managing chronic diseases, including heart disease,” says Wilton. “In the APPROACH program we have been collecting that information for research purposes for more than 20 years, but we have never actually closed the loop to provide an individual patient’s results back to them or their physicians.”
This study will examine ways of doing just that using electronic surveys with a follow-up to see whether patient-reported care and medical outcomes improve for people who have cardiac catherization procedures, routinely given to thousands of Albertans each year to diagnose and treat heart disease.
Currently, all cardiac catherization patients in Alberta receive a survey about a month after they are treated that includes questions about their symptoms, quality of life, mental health, social support system and satisfaction with their treatment. According to Wilton, that information goes into the APPROACH database and has been used to publish a number of important studies highlighting the influence of a patient’s characteristics and treatment on their wellbeing. However, using this type of information to guide clinical care is an innovative approach that has only been done in a few centres.
The IMPROVE CV Care trial, which is funded by the Libin Cardiovascular Institute and the Canadian Institutes of Health Research (CIHR) is one of three projects in an Innovative Clinical Trials Program grant of more than $3 million, which will make that information available to patients and their physicians.
A team of researchers will use this patient-reported data to develop an app to generate patient-specific reports comparing an individual’s data with others similar to them. Data will be collected periodically when most patients are scheduled for a follow up appointment and used to provide a snapshot on a patient’s overall wellness. One of the features of the report will be to flag changes in patient reported wellness, such as mood changes and pain.
Researchers will randomizely select[EB1] [MJ2] cardiologists in Alberta to receive the electronic reports, and then compare patient outcomes and patient-reported quality of life between the two groups of patients – those whose cardiologists did or didn’t receive the information.
“The overall goal is to improve our delivery of patient-centred care,” says Wilton, explaining that the project is being developed in conjunction with a group of patient partners. “We think this is a relatively simple way to tailor care.”
Wilton says the study will be ongoing for the next four years and will include data from more than one thousand patients.
Dr. Matthew James, MD, PhD, research co-director of APPROACH alongside Wilton, says this information will help guide physicians and their patients when making decisions about care, such as the need to change medication or recommend interventions like seeking support for anxiety and depression or connecting with other community supports.
“Patients will report information about how they feel, their experiences and other wellness measures, and this will be compared against other people like them,” says James. “The trial will test the impact of providing more guidance in some of these areas to help people.”