Skip to main content
OpenTrials
Not Yet Recruiting

NCT Number: NCT07706543

Evaluation of a French Hospital Discharge Therapeutic Education Program by Nurses for Heart Failure Patient (EduSor)

Heart failure affects 2.3% of the adult French population. Readmission within 30 days doubles the risk of early death within the following 30 to 60 days, as well as the risk of rehospitalization over the subsequent two years. Incorporating nurse-led discharge education can significantly reduce readmissions for heart failure as well as all-cause readmissions. Drawing on practices from English-speaking countries and Switzerland regarding patient discharge education at hospital, we propose to evaluate a discharge education program in the French hospital setting for patients with heart failure.

The objective of this multicenter before-and-after study is to evaluate the impact of a nurse-led discharge education delivered at hospital on the quality of the care pathway for patients with heart failure, assessed 30 days after hospital discharge. The primary outcome is the reduction in 30-day unplanned all-cause hospital readmissions, including emergency department visits. An informal (non-professional) caregiver may also be enrolled in the study if identified by the patient and present during the hospitalization.

Patients enrolled before implementation of the discharge education will constitute the control group (standard therapeutic patient education group). They will receive usual hospital care, including educational sessions throughout hospitalization covering the disease, treatments, and self-care, as well as a follow-up consultation with a nurse 30 days after hospital discharge. This usual care is referred to as standard therapeutic patient education and does not include a structured therapeutic patient education intervention at hospital discharge.

Patients receiving the discharge education will constitute the intervention group (standard therapeutic patient education with discharge education group). They will receive the same usual care (i.e., standard therapeutic patient education and the 30-day post-discharge nurse follow-up consultation), supplemented by the nurse-led discharge education intervention during their hospitalization.

To minimize the risk of contamination (diffusion bias), the control group will be enrolled and complete follow-up before nurses receive training in the discharge education intervention.

Not Yet Recruiting

Trial opening soon.

Get Notified

Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

CHU Clermont-Ferrand, Clermont-Ferrand, France

Loading trial locations.

About this study

Patients and their informal caregivers will be informed about the study by the nursing staff within the first two days of hospitalization in the cardiology departments participating in the study. Their eligibility will then be assessed, and eligible patients and caregivers will be invited to participate. A participant information sheet describing the study will be provided and explained to both the patient and the informal caregiver.

Patients and their informal caregivers will be given a 24-hour reflection period. After this period, they will have the opportunity to discuss any remaining questions with the investigator nurse, who will provide any necessary clarification. Patients and informal caregivers who agree to participate will then sign the informed consent form and be enrolled in the study. The investigator will also sign the informed consent form.

All participants in the control group will be enrolled simultaneously across the three participating study centers. The same enrollment procedure will be followed for the intervention group.

Patients in the intervention group will receive an initial educational assessment on the day following enrollment, a participatory therapeutic education session using the teach-back method within the 24 hours preceding hospital discharge, a follow-up telephone call from a nurse 7 days after discharge, and a final educational assessment at the routine 30-day post-discharge follow-up visit. Whenever possible, the patient's informal caregiver will be asked to accompany the patient to this follow-up consultation.

A participant may be prematurely withdrawn from the study for any of the following reasons:

  • an intercurrent disease interfering with the normal conduct of the study protocol;
  • death;
  • participant's decision
  • a major protocol deviation;
  • loss to follow-up (a participant is considered lost to follow-up if they fail to attend a scheduled study visit and no information regarding their status can be obtained despite all reasonable efforts to contact them and determine the reason for study discontinuation. The reason "lost to follow-up" will only be assigned after these efforts have been unsuccessful).

Patients and their informal caregivers may participate in another clinical study provided that, in the opinion of the investigator, such participation does not interfere with the conduct or objectives of the present study. Participants must therefore inform the investigator of any concurrent participation in another study, and the investigator will determine whether simultaneous participation is appropriate.

The study may be temporarily suspended or permanently terminated for any of the following reasons:

  • insufficient or no participant recruitment;
  • inability to secure funding for the study;
  • any directive issued by the competent regulatory authorities requiring the temporary suspension or permanent termination of the study;
  • a decision by the sponsor and the coordinating investigator.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patient aged 18 years old or more,
  • Fluent in spoken and written French,
  • Willing to participate in the study,
  • Hospitalized for heart failure in one of the participating centers for at least 2 days,
  • Affiliated with a French social security scheme
  • Discharged either to home or transferred to a Medical and Rehabilitation Care unit.

Exclusion criteria

  • Hospitalized for a reason other than heart failure,
  • Previously included in the study during a prior hospitalization,
  • Presenting with identified cognitive impairment,
  • In a situation deemed inappropriate by the care team (end of life),
  • Living in an institutional setting,
  • Pregnant women,
  • Breastfeeding women,
  • Under legal protective measures,
  • Enrolled in another interventional research study that may interfere with the results of the present study, according to the investigator's judgment.

Treatment and study plan

Nurse-led discharge education

Behavioral

The intervention includes :

  • An initial educational assessment (≈1 h) on the day after enrollment to identify individualized learning needs for discharge and assess key self-management and safety competencies ;
  • An interactive discharge education session (≈1 h) within 24 hours before discharge, using the teach-back method to reinforce warning signs, medication, self-care, follow-up, and healthcare contacts ;
  • A nurse-led follow-up telephone call 7 (±3) days after discharge (15-30 min) to assess competencies and reinforce learning if needed ;
  • A final educational assessment (≈1 h) during the routine 30-day (±7 days) follow-up consultation. Informal caregivers will be invited to participate whenever possible.

Primary outcomes

  1. Unplanned all-cause rehospitalizations, including emergency department visits.

    Time frame: At 30 days after hospital discharge

    Rehospitalization is defined as "an unplanned hospital stay of at least one overnight stay"

Secondary outcomes

  1. Unplanned rehospitalizations, including emergency department visits, for heart failure.

    Time frame: At 30 days after hospital discharge

    Rehospitalizations are assessed using the European Society of Cardiology definition of hospitalization for heart failure. Those that meet the criteria of this definition are classified as heart failure-related readmissions.

  2. Patient death

    Time frame: At 30 days after hospital discharge

  3. Patient satisfaction of the hospital discharge organization

    Time frame: At 30 days after hospital discharge

    Score on the "Hospital Discharge Organization" dimension of the French National Authority for Health "e-Satis+48h MCO" questionnaire, a national patient satisfaction and experience self-administrated questionnaire for hospitalized patients

  4. Scheduled rehospitalizations that were not completed.

    Time frame: At 30 days after hospital discharge

  5. Number of consultations with the patient's primary care physician.

    Time frame: At 30 days after hospital discharge

  6. Scheduling of a cardiology consultation (appointment made).

    Time frame: At 30 days after hospital discharge

  7. Daily adherence to cardiovascular medication

    Time frame: At baseline

    Measurement of cardiovascular medication adherence using the self-administered MASCARD questionnaire

  8. Daily adherence to cardiovascular medication

    Time frame: At 30 days after hospital discharge

    Measurement of cardiovascular medication adherence using the self-administered MASCARD questionnaire

  9. Number of warning signs and self-care behaviors cited by the patient.

    Time frame: At 30 days after hospital discharge

    Warning signs : Shortness of breath - Rapid weight gain - Lower limb edema - Fatigue Sel-care behaviors: Physical activity - Weighing oneself - Medication adherence - Avoiding added salt

  10. Heart failure self-care behaviors

    Time frame: At baseline

    Assessed using the European Heart Failure Self-Care Behaviour Scale-9 (EHFScB-9) self-administered questionnaire

  11. Heart failure self-care behaviors

    Time frame: At 30 days after hospital discharge

    Assessed using the European Heart Failure Self-Care Behaviour Scale-9 (EHFScB-9) self-administered questionnaire

  12. Completeness rate of remote monitoring data transmission for patients enrolled in telemonitoring

    Time frame: At 30 days after hospital discharge

    Weight, blood pressure, oxygen saturation

  13. Number of alerts and number of medically managed alerts, generated through remote monitoring for patients enrolled in telemonitoring

    Time frame: At 30 days after hospital discharge

  14. Self-perceived patient competence in disease management

    Time frame: At baseline

    Assessed using a 0-5 "skills star" scale (management of medications, management of follow-up appointments, recognition of warning signs, and implementation of self-care behaviors).

  15. Self-perceived patient competence in disease management

    Time frame: At 30 days after hospital discharge

    Assessed using a 0-5 "skills star" scale (management of medications, management of follow-up appointments, recognition of warning signs, and implementation of self-care behaviors).

  16. Self-perceived patient competence in contacting and alerting the care team when experiencing difficulties in their care pathway

    Time frame: At baseline

    Assessed using a 0-5 "skills star" scale (communication with healthcare professionals).

  17. Self-perceived patient competence in contacting and alerting the care team when experiencing difficulties in their care pathway

    Time frame: At 30 days after hospital discharge

    Assessed using a 0-5 "skills star" scale (communication with healthcare professionals).

  18. Anxiety and depression of patients

    Time frame: At baseline

    Assessed using the self-administrated Hospital Anxiety and Depression Scale (HADS).

  19. Anxiety and depression of patients

    Time frame: At 30 days after hospital discharge

    Assessed using the self-administrated Hospital Anxiety and Depression Scale (HADS).

  20. Informal caregiver burden

    Time frame: At baseline

    Assessed using the Mini-Zarit self-administered questionnaire.

  21. Informal caregiver burden

    Time frame: At 30 days after hospital discharge

    Assessed using the Mini-Zarit self-administered questionnaire.

  22. Cost-effectiveness and budget impact medico-economic analysis of discharge education.

    Time frame: At 30 days after hospital discharge

    Incremental cost-effectiveness ratio of discharge education and the bundled payment amount compatible with the financial sustainability of discharge education.

Study contacts

Contact information is provided by the study sponsor or research team.

Lise Laclautre

CONTACT

[email protected]

0473754963

Sponsors and collaborators

Lead sponsor

University Hospital, Clermont-Ferrand

Other

Registry information

Official study title

Evaluation of a Therapeutic Patient Education Program for Discharge (ETPsh) by Nurses in a French Hospital Setting Among Patients With Heart Failure

Acronym: EDUSOR

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Jul 15, 2026
Registry last updated
Jul 15, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.