Community paramedic management for heart failure at home

Community Paramedic Heart Failure Management (CP-HF) Program

This project will try having community paramedics visit adults with heart failure at home to see if home-based care reduces hospital stays, emergency visits, and improves quality of life compared with standard care.

Quick facts

• Study type: Observational
• Enrollment: 75 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Mayo Clinic (Academic / other)
• Locations: 1 site (Rochester, Minnesota)
• Trial ID: NCT06874556 on ClinicalTrials.gov

What this trial studies

This observational program uses community paramedics to provide at-home management and monitoring for adults with heart failure, including patients eligible for early discharge, those at home needing large-volume diuresis, and Stage D patients who require frequent diuretic adjustments. Care includes home visits for clinical assessment, diuretic management, and coordination with the patient’s Mayo Clinic cardiologist or primary care provider. Investigators will examine outcomes such as quality of life, hospital admissions, emergency department use, patient and clinician satisfaction, and costs compared with standard care. The work is being conducted at Mayo Clinic in Rochester, Minnesota to assess feasibility and real-world impact.

Who should consider this trial

Good fit: Ideal candidates are adults with heart failure who are eligible for early discharge with paramedic support, are at home needing large-volume diuresis without hospital-level monitoring, or are Stage D patients requiring frequent diuretic adjustments.

Not a fit: Patients who need hospital-level monitoring, are in hospice or skilled nursing facilities, are pregnant, lack a Mayo Clinic cardiologist or primary care clinician, have active substance abuse or behavioral issues, or cannot communicate reliably are unlikely to benefit or be eligible.

Why it matters

Potential benefit: If successful, this approach could lower hospital and emergency visits and improve quality of life for heart failure patients while reducing costs.

How similar studies have performed: Similar community paramedic and home-based heart failure programs have shown promising pilot results for reducing admissions and emergency visits, but larger controlled studies are limited.

Eligibility criteria

Inclusion Criteria:

One of the following criteria:

1. Adults admitted to the hospital with decompensated HF eligible for early discharge with CP support and monitoring.
2. Acutely decompensated HF patients at home or being evaluated in the ambulatory clinic who require large volume diuresis but do not require hospital-level monitoring.
3. Stage D advanced HF patients who require frequent (\>weekly) diuretic adjustments (either inpatient or outpatients).

Exclusion Criteria:

1. Hospital-level monitoring or care is clinically indicated.
2. Failed safety assessment, active substance abuse, or behavioral health diagnosis which could impact participation.
3. Enrolled in hospice.
4. Patient is a resident in a skilled nursing facility.
5. Patient does not have a primary care physician or cardiologist at Mayo Clinic.
6. Patient participants with communication barriers due to medical illness or cognitive impairment.
7. Pregnant

Where this trial is running

Rochester, Minnesota

• Mayo Clinic — Rochester, Minnesota, United States (Recruiting)

Study contacts

• Principal investigator: Sara Severson, APRN, C.N.P. — Mayo Clinic
• Study coordinator: Sara Biorn

Conditions Heart Failure