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Enhancing Cardiac Rehabilitation Attendance After Secondary Myocardial Infarction Through Clinician Messaging and Motivational Calls

Sponsor: Massachusetts General Hospital • ClinicalTrials.gov ID: NCT07485491

Registry updated: 2026-09-23

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Description

The goal of this clinical trial is to determine if a behavioral intervention can increase attendance at cardiac rehabilitation (CR) after secondary/type 2 myocardial infarction in adult patients. The main question it aims to answer is: * Does the ATTEND-CR intervention increase attendance at ≥1 CR exercise session within 140 days of randomization? * Does the intervention increase completion of ≥12 CR exercise sessions within 140 days of randomization? Researchers will compare participants receiving the ATTEND-CR intervention (clinician notifications and a motivational interviewing participant phone call) to usual care to see if attendance and completion of CR improve. Participants: * Clinicians will receive informational messaging regarding CR and the referral process * Participate in a motivational interviewing phone call (intervention group only) * Have follow-up assessments via telephone and electronic health record (EHR) review to track CR attendance, clinical events, and health outcomes

Interventions

Clinician-level intervention (Behavioral)
The inpatient clinical team receives an EPIC in-basket and email detailing the patient's study participation, benefits of cardiac rehabilitation, and guidance on how to place a cardiac referral if appropriate. If a cardiac rehabilitation referral is not placed within 3 days post-discharge, a follow-up message is sent to one of the patient's outpatient clinician within 4-28 days post-discharge and within 140 days of randomization.
Patient-level intervention (Behavioral)
Participants receive a phone call applying motivational interviewing principles if a cardiac rehabilitation referral has been placed by their clinical team within 56 days post-discharge and within 140 days of randomization. The phone call aims to discuss cardiac rehabilitation, barriers to participation, and support engagement in cardiac rehabilitation.

Eligibility criteria

Inclusion Criteria: * Age ≥ 18 years * Inpatient at MGH with an index likely or confirmed secondary MI * Primary care provider (PCP) within the Mass General Brigham (MGB) network with at least one visit in the past 2 years * Anticipated ability to ambulate independently without walking aids or supplemental ambulatory oxygen at discharge * Ability to provide informed consent Exclusion Criteria: * Known severe untreated valvular heart disease or severe prosthetic valve dysfunction * Known hypertrophic obstructive cardiomyopathy * End-stage heart failure (VAD, transplant patient, or undergoing evaluation for VAD or transplant) * Hemodynamic instability at the time of pre-screening * Terminal illness with life expectancy \< 1 year * Severe anemia (hemoglobin \< 8 g/dL) at the time of pre-screening * Active, unstable cancer (excluding non-metastatic skin cancer) or currently receiving intensive cancer therapy * Advanced kidney disease requiring renal replacement therapy * Receiving palliative or comfort care only * Recurrent falls (≥2) or falls with injury in the past year * Physical or cognitive impairment likely to prevent safe participation in exercise over the next 5 months (e.g., significant stroke deficits, dementia) * High-risk for non-adherence to study requirements * Incarcerated individuals * Currently pregnant or within 3 months postpartum * Previously referred to or participated in CR within the past year * Alternative MI subtype (spontaneous \[type 1 MI\] or procedural MI \[type 4 or 5 MI\]) in the past 6 months * Suspected or confirmed coronary mechanism of index MI (vasospasm, embolism, or spontaneous coronary artery dissection) * Anticipated discharge or discharged before enrollment measures can be completed * Anticipated discharge to a facility where independent participation in CR is not feasible * Previously enrolled in or declined participation in this study

Conditions

Type 2 Myocardial Infarction

Locations

Massachusetts General Hospital — Boston, Massachusetts, United States

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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