Study Type
Observational
completed
The goal of the PACT-HF study was for all patients hospitalized with heart failure (HF), in 10 large hospitals in Canada, to receive self-care education, multidisciplinary care services, and early follow-up with their primary health care providers; and for high-risk patients to receive nurse-led home visits and outpatient care in heart function clinics following hospital discharge.
We redesigned workflow to integrate health care services across institutions and regional networks that typically work independently of each other.
We obtained clinical outcomes via linkages to provincial administrative databases, analyzing them using shared frailty survival models adjusted for the stepped wedge design.
We analyzed secondary outcomes using hierarchical models adjusted for the stepped wedge design. We applied the Intention-to-treat principle for all analyses.
Primary outcomes:
- Time to 3-month composite all-cause readmissions, emergency department (ED) visits, and death.
- 30-day composite all-cause readmissions and ED visits.
Secondary outcome:
- Patient-reported discharge preparedness
- Care transitions quality
- Health-related quality of life
- Quality-adjusted life years
Study Design
Stepped wedge cluster RCT
NO. of Countries
1
NO. of Sites
10
NO. of Participants
2494
Study Period
2015-2016
Sponsor
PHRI
Harriette Van Spall
Senior Scientist
Harriette Van Spall
Senior Scientist
Harriette Van Spall is currently an Associate Professor in the Division of Cardiology, Department of Medicine, at McMaster University. She also serves as a Cardiologist at Hamilton Health Sciences and is a Scientist at the Population Health Research Institute and the Research Institute of St. Joe’s, Hamilton. Additionally, she is an Associate Member of the Department of Health Research Methods, Evidence, and Impact. Van Spall obtained her Bachelor of Science and Doctor of Medicine degrees and completed postgraduate training at the University of Toronto. She then earned a Master of Public Health degree from the Harvard School of Public Health. As a fellow of the Royal College of Physicians and Surgeons of Canada, she holds certifications in Internal Medicine, Cardiology, and Level III Echocardiography, with appointments in both the Department of Medicine and the Department of Health Research Methods, Evidence, and Impact at McMaster University.
Van Spall is a full-time cardiologist with a clinical focus on Heart Failure, Echocardiography, and Acute Care Cardiology. She is a data scientist and clinical trialist with expertise in heart failure, health research methods, and implementation science. Van Spall leads both industry-sponsored and investigator-initiated phase III trials and is well known for her work in health and research equity. She is a primary research supervisor and mentor to several medical trainees, graduate students, and postgraduate fellows.
Van Spall has published more than 220 manuscripts, with a significant proportion appearing in high-impact medical journals, including JAMA, Lancet, Annals of Internal Medicine, Circulation, JACC, and European Heart Journal. She has received several prestigious research awards, including the Canadian Institutes of Health Research-Institute of Circulatory and Respiratory Health Mid-Career Lectureship Award in Cardiovascular Sciences and the American Heart Association Dr. Nanette K. Wenger Research Goes Red Award. Van Spall has secured over $6.0 million in peer-reviewed funding from the Canadian Institutes of Health Research (CIHR), the Heart and Stroke Foundation of Canada, and other funding agencies. She is an invited speaker at international cardiovascular conferences, a media correspondent, and an editorial board member for leading journals. Additionally, she is a chair or member of several international research networks, trial executive committees, and guideline committees.
Canadian Institutes of Health Research (CIHR)
Ministry of Health and Long Term Care
VIDEO: Harriette Van Spall on PACT-HF at AHA 2019
