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.
Stepped wedge cluster RCT
Harriette Van Spall is a Scientist for the Arrhythmia and Heart Failure research program and the Knowledge Translation and Health Systems program at PHRI, an Associate Professor, Department of Medicine (cardiology) at McMaster University. Her research, supported by CIHR and the Ministry of Health, is in quality of care and outcomes, knowledge translation, and health systems improvement pertaining to heart failure. She has won several research awards, and her work has been published in high-impact medical journals, including JAMA, Lancet, Circulation, and Annals of Internal Medicine.
She earned her Doctor of Medicine degree from the University of Toronto, and a Master of Public Health degree from the Harvard School of Public Health. She completed postgraduate training in Internal Medicine, Cardiology, and Echocardiography at the University of Toronto.
Associate Program Manager
Heather Beresh has worked at PHRI since May 2002, largely devoted to managing global, multi-centre clinical trials of antithrombotic therapies in patients with atrial fibrillation (AF). She started as research coordinator for the ACTIVE study evaluating dual antiplatelet therapy and angiotensin receptor blockers in patients with AF, then continued with oversight of the AVERROES open label extension trial evaluating a novel oral anticoagulant in the same population, and ARTESiA evaluating anticoagulant therapy in patients with subclinical AF.
In addition, she has coordinated trials of ablation procedures versus anti-arrhythmic medications and trials evaluating screening strategies for AF. Heather also manages network collaborations, including the Canadian Stroke Prevention Intervention Network (CSPIN). She has as a Master’s degree in Medical Sciences from McMaster University.
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