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Congenital Heart DiseaseAPPROACH-IS IINCT04902768

Assessment of Patterns of Patient Reported Outcomes in Adults With Congenital Heart Disease - International Study II

An observational study of Congenital Heart Disease, run by KU Leuven at 53 sites in 32 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is an international, cross-sectional and descriptive study that aims to investigate differences in patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) and that aims to explore the profile and healthcare needs of adults with congenital heart diseases. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Congenital Heart Disease
How many people
8,415 participants
Where
53 sitesin 32 countries
Study dates
1 Aug 2019to 31 Dec 2022
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adults with congenital heart disease who are in follow-up at an adult congenital heart disease center or included in a national/regional registry. For Part 1 of this study, each participating center will aim to recruit 200 adult patients with CHD aged 18 years or older with simple, moderate, or complex congenital heart disease. For Part 2 of this study, within these samples of 200 patients, centers will aim to recruit about 20 adults aged 40-50y, 20 adults aged 50-60y and 20 adults aged >60 years who are diagnosed with moderate to great disease complexity. Depending on the data collection method, sampling is at random or consecutive. Both a probability and convenience sample can be used.

Who may be able to join

  • Diagnosed with congenital heart disease, defined as: "a gross structural abnormality of the heart and/or intra-thoracic great vessels that is actually or potentially of functional significance (including mild, moderate, and complex heart defects)"
  • Aged 18 years of age or older at the moment of study inclusion
  • Diagnosed with congenital heart disease before the age of 10 years
  • Follow-up at an ACHD center or included in a national/regional registry
  • Physical, cognitive, and language abilities to complete self-report questionnaires

Who cannot join

  • Prior heart transplantation

Trial locations and contacts

53 sites in 32 countries.

53 sites in 32 countries

United States10 sites
  • Taussig Heart Center of Johns Hopkins Hospital

    Baltimore, Maryland, 21287

  • Boston Children's / Brigham and Women's

    Boston, Massachusetts, 02115

  • Nationwide Children's Hospital

    Columbus, Ohio, 43205

  • University of Southwestern Medical Center

    Dallas, Texas, 75390

  • University of Florida Health

    Gainesville, Florida, 32611

  • Mount Sinai Heart

    New York, New York, 10029

  • Philadelphia Penn Medicine

    Philadelphia, Pennsylvania, 19104

  • Oregon Health and Science University

    Portland, Oregon, 97239

  • University of California

    San Francisco, California, 92093-0021

  • Lucile Packard Children's Hospital and Stanford Health Care

    Stanford, California, 94304

Other trials in United States

Sweden5 sites
  • Sahlgrenska University Hospital

    Gothenburg

  • Skånes Universitetssjukhus

    Lund

  • Karolinska Universitetssjukhuset

    Stockholm

  • Umea University Hospital

    Umeå

  • Uppsala University Hospital

    Uppsala

Other trials in Sweden

France3 sites
  • Hôpital cardiologique Haut-Leveque

    Bordeaux

  • Montpellier University Hospital

    Montpellier

  • Hôpital Européen Georges Pompidou

    Paris

Other trials in France

Switzerland3 sites
  • University Hospital Bern

    Bern

  • Hôpitaux Universitaires de Genève

    Geneva

  • Centre Hospitalier universitaire vaudois

    Lausanne

Other trials in Switzerland

Argentina2 sites
  • Hospital San Juan De Dios De La Plata

    Buenos Aires

  • Hospital de Niños

    Córdoba

Other trials in Argentina

Belgium2 sites
  • Ghent University Hospital

    Ghent

  • University Hospitals Leuven

    Leuven

Other trials in Belgium

Canada2 sites
  • Mazankowski Alberta Heart Institute

    Edmonton

  • Montreal Heart Institute, Université de Montréal

    Montreal

Other trials in Canada

United Kingdom2 sites
  • Royal Brompton Hospital, Royal Brompton & Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust

    London

  • Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust

    Newcastle

Other trials in United Kingdom

Australia1 site
  • Melbourne Children's Cardiology

    Melbourne

Other trials in Australia

Austria1 site
  • Vienna General Hospital

    Vienna

Other trials in Austria

Botswana1 site
  • Princess Marina Hospital

    Gaborone

Other trials in Botswana

Brazil1 site
  • Hospital das Clinicas da Faculdade de Medicina de Ribeirão Preto

    Ribeirão Preto

Other trials in Brazil

Bulgaria1 site
  • National Heart Hospital

    Sofia

Other trials in Bulgaria

Cameroon1 site
  • Clinique Medical Le Jourdain

    Yaoundé

Other trials in Cameroon

Chile1 site
  • Intituto Nacional Del Torax

    Santiago

Other trials in Chile

Colombia1 site
  • Meintegral Clinic

    Manizales

Other trials in Colombia

Denmark1 site
  • Copenhagen University Hospital

    Copenhagen

Other trials in Denmark

Ethiopia1 site
  • College of Health sciences, Addis Ababa University

    Addis Ababa

Other trials in Ethiopia

Greece1 site
  • AHEPA University Hospital

    Thessaloniki

Other trials in Greece

India1 site
  • Amrita Institute of Medical Sciences

    Kochi

Other trials in India

Italy1 site
  • Policlinico San Donato (IRCCS)

    Milan

Other trials in Italy

Japan1 site
  • Chiba Cerebral and Cardiovascular Center

    Chiba

Other trials in Japan

Malaysia1 site
  • Paediatric & Congenital Heart Centre, IJN (National Heart Institute)

    Kuala Lumpur

Other trials in Malaysia

Malta1 site
  • Mater Dei Hospital

    Msida

Other trials in Malta

Netherlands1 site
  • Centrum voor Congenital Hartafwijkingen

    Groningen

Other trials in Netherlands

Norway1 site
  • Oslo University Hospital, Rikshospitalet

    Oslo

Other trials in Norway

Pakistan1 site
  • Aga Khan University Hospital

    Karachi

Other trials in Pakistan

Portugal1 site
  • Reference Center of Congenital Heart Disease , University Hospital Center of São João

    Porto

Other trials in Portugal

Senegal1 site
  • Centre Hospitalier Régional de Thiès

    Thiès

Other trials in Senegal

South Korea1 site
  • Samsung Medical Center

    Seoul

Other trials in South Korea

Taiwan1 site
  • National Taiwan University Hospital

    Taipei

Other trials in Taiwan

Turkey (Türkiye)1 site
  • Ege University Health Application and Research Center, Cardiology Department

    Bornova

Other trials in Turkey (Türkiye)

About this study

Official title: APPROACH-IS II: Assessment of Patterns of Patient Reported Outcomes in Adults With Congenital Heart Disease - International Study II

This is an international, cross-sectional and descriptive study that aims to investigate differences in patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) and that aims to explore the profile and healthcare needs of adults with congenital heart diseases.

Read the detailed description

The research aims of this study are:

  1. To further explore differences in a modified selection of patient-reported outcome measures (PROMs) and (as a new addition in APPROACH-IS II) explore differences in patient-reported experience measures (PREMs), by enrolling adults with congenital heart diseases in low, middle, and high income countries and including new potential explanatory variables ("Part 1").
  2. To explore the profile and healthcare needs of a subgroup of older adults with congenital heart disease, with a particular focus on investigating the frailty phenotype ("Part 2").
Being tested
This is an observational study, there is no intervention
Keywords
Congenital Heart Disease, Quality of life, Patient reported outcomes, Patient reported experience measures, Geriatric phenotype
Medical subject headings
Heart Defects, Congenital

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • This is an observational study, there is no interventionOther

    This is an observational study, there is no intervention. Hence, this is not applicable.

Study groups in NCT04902768
Study groupRoleWhat they receive
Adults with congenital heart diseaseNot described
Receives: Other: This is an observational study, there is no intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Patient-reported health status

    This outcome is measured using the shortened version of the RAND-36. Composite physical (PCS) and mental health (MCS) scores are computed. Scores range from 0 (lowest health level) to 100 (highest health level).

    Measured: Baseline

  2. Patient-reported health status

    This outcome is measured using the Linear Analogue Scale Health Status (LAS HS). Scores range from 0 (worst imaginable health state) to 100 (best imaginable health state).

    Measured: Baseline

  3. Patient-reported depressive symptoms

    This outcomes is measured using the Patient Health Questionnaire 8. Scores range from 0 to 24. Scores of ≥10 indicate depression.

    Measured: Baseline

  4. Patient-reported anxiety symptoms

    This outcome is measured using the General Anxiety Disorder 7. Scores range from 0 to 21. Scores of 5, 10, and 15 are taken as cut-off points for mild, moderate and severe anxiety.

    Measured: Baseline

  5. Patient-reported quality of life

    This outcome is measured using the Linear Analog Scale on Quality of Life (LAS QOL). Scores range from 0 (worst imaginable quality of life) to 100 (best imaginable quality of life).

    Measured: Baseline

  6. Patients' perception of providers' autonomy support

    This outcome is measured using the modified Health Care Climate Questionnaire (mHCCQ). Each of the 6 items is scored from 1 to 7. Scores are calculated by averaging the individual item scores. Higher average score represents a higher level of perceived autonomy support.

    Measured: Baseline

  7. Cognitive functioning

    This outcome is measured using the Montreal Cognitive Assessment Screener (MoCA). Scores range from 0 to 30. Scores of <26 indicate cognitive dysfunction.

    Measured: Baseline

  8. Frailty phenotype

    This outcome is classified using the Fried method (i.e., non-frail (no positive criterion), pre-frail (1 or 2 criteria positive), or frail (when ≥3 criteria are positive).

    Measured: Baseline

Secondary outcomes (12)
  1. Patient-reported stigma

    This outcome is measured using the Chronic Illness Stigma Scale (CISS). Scores range from 8 to 40. Higher scores indicating higher levels of perceived stigma.

    Measured: Baseline

  2. Patient-reported illness identity

    This outcome is measured using the Illness Identity Questionnaire (IIQ). The questionnaire consists of a five-item rejection scale, seven-item enrichment scale, five-item acceptance scale and eight-item engulfment scale. A mean score is calculated per subscale. Higher scores indicate more rejection, enrichment, acceptance or engulfment.

    Measured: Baseline

  3. Patient-reported empowerment

    This outcome is measured using the Gothenburg Empowerment Scale (GES generic v1.1). Scores range from 15 to 75. Higher score reflects a higher level of empowerment.

    Measured: Baseline

  4. Patient-reported healthcare utilization

    This outcomes was measured using the Patient-Reported Inpatient and outpatient Utilization Survey (PRIUS). Higher numbers indicate more healthcare use.

    Measured: Baseline

  5. Patient-reported functional status

    This outcome is classified according to the New York Heart Association (NYHA).

    Measured: Baseline

  6. Patient-reported social support

    This outcomes is measured using the Multidimensional Scale on Perceived Social Support Scale (MSPSS). Scores range from 12 to 84. Higher score indicates greater social support perceived by an individual.

    Measured: Baseline

  7. Patient-reported parental involvement

    This outcome is measured using an adapted version of the subscale on parents of the Multidimensional Scale on Perceived Social Support. Scores range from 5 to 35. Higher score indicates greater parental support in childhood and adolescence.

    Measured: Baseline

  8. Advance care planning

    This outcome is measured using a survey developed for APPROACH-IS II by the Steering Committee, based on previous research. A sample question is 'Have you personally written down information about the care you would want in case you become seriously ill in the future?'.

    Measured: Baseline

  9. Patient-reported social media to connect with peers

    This outcome is measured using a survey developed for APPROACH-IS II by the Steering Committee, based on previous research. A sample question is 'How would you describe your experiences connecting with other people with CHD through social media?'.

    Measured: Baseline

  10. Presence and burden of comorbidities

    This outcome is measured using the Charlson Comorbidity Index.

    Measured: Baseline

  11. Patient-reported socio-demographic variables (eg. age, educational level)

    Self-reported

    Measured: Baseline

  12. Medical variables by chart review (eg. diagnosis, cardiac surgeries)

    This outcome is classified according to the adult congenital heart disease anatomic and physiological (ACHD AP) classification system of Stout and colleagues.

    Measured: Baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 May 2021
  2. Study start1 Aug 2019
  3. Primary completion31 Aug 2022
  4. Study completion31 Dec 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case only
Time perspective
Cross-sectional
Enrolment
8,415 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04902768
Sponsor's protocol ID
S62537
Acronym
APPROACH-IS II
Status last verified
May 2024
First submitted
20 May 2021
Last updated
16 May 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Well-argued and reasonable requests can be directed to the Principal Investigator (Prof. Philip Moons) of the study.

Publications

  • Van Bulck L, Goossens E, Kovacs AH, Luyckx K, Ladak LA, Leye M, Van De Bruaene A, Leong MC, Kaneva A, Pavao RB, Araujo JJ, Sasikumar N, Gabriel H, Goshu DY, Lu CW, Enomoto J, Areias ME, Kosmidis D, Coats L, Valente AM, Moon JR, Ladouceur M, Thomet C, Jackson JL, Sandberg C, Callus E, Kim YY, Lykkeberg B, Alday L, Bredy C, Saidi A, Reyes FB, Menahem S, de Hosson M, Mandelenakis Z, Christersson C, Zaidi A, Johansson B, Andresen B, Ambassa JC, Mattsson E, Constantine A, Amedro P, van Melle JP, Cedars A, Ortiz L, Demir F, Khairy P, Windram J, Bouchardy J, Caruana M, Jameson SM, Mahadevan VS, McGrath LB, Mwita JC, Moons P; APPROACH-IS II consortium, International Society for Adults Congenital Heart Disease (ISACHD). Advance Care Planning in Adults With Congenital Heart Diseases: Current Practices, Preferences, and Needs of 8,281 Adults From 32 Countries. Can J Cardiol. 2026 Jun;42(6):1338-1348. doi: 10.1016/j.cjca.2025.12.039. Epub 2026 Jan 8.

    PubMed 41519299
  • Ansari Ramandi MM, Van Bulck L, Ceelen DCH, Voors AA, Goossens E, Kovacs AH, Luyckx K, Van De Bruaene A, Gabriel H, Lykkeberg B, Thomet C, de Hosson M, Ladouceur M, Saidi A, Kosmidis D, Areias ME, Miranda J, Sandberg C, Mandalenakis Z, Coats L, Amedro P, Khairy P, Valente AM, Johansson B, Kaneva A, Andresen B, Christersson C, Baraona Reyes F, Hlebowicz J, Enomoto J, Kim YY, Menahem S, Yang HL, Moon JR, Bredy C, Schmidt A, Callus E, Araujo JJ, Constantine A, Zaidi A, Bouchardy J, Jameson SM, Kutty S, McGrath LB, Leong MC, Ortiz L, Demir Korkmaz F, Caruana M, Leye M, Moons P, van Melle JP; APPROACH-IS II Consortium; International Society for Adults With Congenital Heart Disease. Quality of Life in Adults With Transposition of the Great Arteries With a Systemic Right or Left Ventricle. Can J Cardiol. 2025 Dec;41(12):2544-2553. doi: 10.1016/j.cjca.2025.09.010. Epub 2025 Sep 15.

    PubMed 40962221
  • Moons P, Kovacs AH, Goossens E, Luyckx K, Ladak L, Leye M, Van De Bruaene A, Leong MC, Kaneva A, Manso PH, Araujo JJ, Sasikumar N, Gabriel H, Yadeta D, Wang JK, Enomoto J, Areias ME, Kosmidis D, Coats L, Valente AM, Moon JR, Ladouceur M, Thomet C, Jackson JL, Sandberg C, Callus E, Kim YY, Lykkeberg B, Alday L, Bredy C, Saidi A, Baraona Reyes F, Menahem S, de Hosson M, Hlebowicz J, Christersson C, Zaidi AN, Johansson B, Andresen B, Ambassa JC, Mattsson E, Constantine A, Amedro P, van Melle JP, Kutty S, Ortiz L, Demir F, Khairy P, Windram J, Bouchardy J, Caruana M, Jameson SM, Mahadevan VS, McGrath LB, Mwita JC, Van Bulck L; APPROACH-IS II consortium, on behalf of the International Society for Adults Congenital Heart Disease (ISACHD). Perceived health, psychological distress and quality of life in 8415 adults with congenital heart disease from 32 countries. Heart. 2025 Aug 12;111(17):818-827. doi: 10.1136/heartjnl-2024-325296.

    PubMed 40579213
  • Moons P, Goossens E, Luyckx K, Kovacs AH, Andresen B, Moon JR, Van De Bruaene A, Rassart J, Van Bulck L; APPROACH-IS II consortium and ISACHD. The COVID-19 pandemic as experienced by adults with congenital heart disease from Belgium, Norway, and South Korea: impact on life domains, patient-reported outcomes, and experiences with care. Eur J Cardiovasc Nurs. 2022 Aug 29;21(6):620-629. doi: 10.1093/eurjcn/zvab120.

    PubMed 34927192

Questions about this trial

What is this clinical trial studying?

An observational study of Congenital Heart Disease, run by KU Leuven at 53 sites in 32 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 May 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 53 sites in United States, Sweden, France, Switzerland, Argentina and 27 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Patient-reported health status (time frame: Baseline). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04902768, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 May 2024.

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