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Note: This record shows only the 20 elements of the WHO Trial Registration Data Set. To view changes that have been made to the source record, or for additional information about this trial, click on the URL below to go to the source record in the primary register.
Register: Netherlands Trial Register
Last refreshed on: 28 April 2013
Main ID:  NTR2490
Date of registration: 01/09/2010
Primary sponsor: University Medical Center Utrecht (UMCU)
Public title: Strategy to recognize and initiate treatment of chronic heart failure (STRETCH).
Scientific title: A combined diagnostic-therapeutic strategy to optimize management of patients with previously unrecognized heart failure in primary care. - STRETCH
Date of first enrolment: 1/10/2010
Target sample size: 1500
Recruitment status: pending
URL:  http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2490
Study type:  intervention
Study design:  Randomised: Yes; Masking: Single; Control: Active; Group: Parallel; Type: 2 or more arms, randomized  
Countries of recruitment
The Netherlands
Contacts
Name: F.H.  Rutten
Address:  Utrecht The Netherlands
Telephone: +31 (0)88 7568051
Email: F.H.Rutten@umcutrecht.nl
Affiliation: 
Name: Evelien E.S.  Riet, van
Address:  Stratenum 5.143 3508 GA Utrecht The Netherlands
Telephone: +31 (0)6 0887568363
Email: E.E.S.vanRiet@umcutrecht.nl
Affiliation: 
Key inclusion & exclusion criteria
Inclusion criteria: 1. Age 65 years or over;

2. Shortness of breath as reason for GP contact in the previous 12 months.

Exclusion criteria: 1. Already established heart failure, that is a diagnosis of heart failure confirmed by the cardiologist with echocardiography;

2. A life expectancy shorter than 6 months;

3. Not being able to give informed consent.


Age minimum:
Age maximum:
Gender:
Health Condition(s) or Problem(s) studied
Heart failure

Intervention(s)
Training of general practitioners in up-titration of heart failure medication. General practitioners in the intervention group will receive a single training of 2 hours from a cardiologist. The uptitrationschema of ACE-inhibitors and betablockers (based on the newest version of the NHG-standard 'Heartfailure') will be discussed and considered are the unwanted effects, interactions and contra-indications. Practical examples are being used.
Primary Outcome(s)
The primary outcome of the diagnostic part of our combined diagnostic-therapeutic strategy is:

1. Prevalence of 'systolic' and 'diastolic' heart failure in elderly who presented to the general practitioner with shortness of breath on exertion.



The primary outcomes of the therapeutic part of our combined diagnostic-therapeutic strategy are:

1. Differences in prescription of ACE-inhibitors and beta-blockers between the intervention and control group after 6 months follow-up;

2. Differences in quality of life between patients in the two groups after 6 months follow-up.
Secondary Outcome(s)
1. Differences in heart failure related doctor-appointments and hospitalization rates between the intervention and control group during 6 months follow-up;

2. Cost-effectiveness of the implemented diagnostic-therapeutic strategy.
Secondary ID(s)
2009B048
Source(s) of Monetary Support
Netherlands Heart Foundation (NHS, Nederlandse Hartstichting)
Secondary Sponsor(s)
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