Risk-guided disease management in coronary artery disease (Risk-Guided CAD)
Principal researchers: Associate Professor Melinda Carrington
Associate researchers: Professor Tom Marwick, Dr Quan Huynh, Associate Professor Jo-anne Manski-Nankervis, Professor Brian Oldenburg, Dr Dominika Kwasnicka, Dr Erin Howden, Professor Garry Jennings, Professor David Thompson and Dr Deepak Haikerwal
Coronary artery disease (CAD) is the number one cause of death of Australians with a high risk for a recurrent event(s) and hospital readmission. Many of these readmissions can be prevented with better management once patients are discharged to home. Identifying patients who may be more likely to be readmitted would allow targeting more intensive management after an acute CAD event for these higher risk individuals.
Disease Management Programs (DMP) and cardiac rehabilitation programs are known to improve cardiovascular outcomes, risk factors and enhance knowledge and overall quality of life. In particular, a DMP led by nurses who interacts with other health professionals/providers can help with education and counselling, taking medications correctly and making healthy lifestyle changes. Current approaches to traditional models have tended to be insufficient with low uptake rates and during COVID-19, the practice of social isolation has disrupted the typical delivery and access to routine health care. Newer models of DMPs that make use of mobile devices (such as an "app") and telehealth (by phone or video call) to monitor and manage health could facilitate CAD management.
Therefore, the aim of this study is to apply a readmission risk score to people who have been hospitalised with CAD and to test a type of nurse-led, e-Health DMP for higher risk patients who are deemed to be more likely to be readmitted. We will conduct a randomised controlled trial to compare our Risk-Guided DMP with usual care over short term (30 days and 90 days) and longer term follow-up (12 months). We envisage that our Risk-Guided DMP will be favourable to patients and associated with high-level participation. We hypothesise that patients allocated to receive the Risk-Guided DMP will have reduced hospital readmissions or death compared to patients who receive usual care.
This trial is supported by research grants awarded to the study investigators, including:
- Heart Foundation Vanguard Grant (APP ID: 104773)
- HCF Research Foundation
- Perpetual IMPACT funding (IPAP 2020/01606)
- Baker Department of Cardiometabolic Health
Risk-Guided CAD is a collaborative project between the Baker Heart and Diabetes Institute, Heartwest, The University of Melbourne and Queens University (Belfast).