RecruitingNot ApplicableNCT06847438

Tailored Electronic Intervention to Improve Therapy in a Diverse Cohort of Patients With Heart Failure

Sponsor

Emory University

Enrollment

4,000 participants

Start Date

Mar 24, 2025

Study Type

INTERVENTIONAL

Conditions

Heart Failure

Summary

Recent medical guidelines for the management of heart failure (HF) have established a combination of specific classes of medications as the best treatment for patients with heart failure with reduced ejection fraction (HFrEF). However, studies have shown that these medications, known together as guideline-directed medical therapy (GDMT), are not being used in clinical practice less often than they could be. Several tools to promote broader use of these treatments (including patient checklists) have shown promise for increasing use of GDMT. However, these tools have not been broadly implemented within large health systems. The goal of this study is to see if using these tools broadly within cardiology clinics will increase the use of GDMT. This study is important because it could help improve the use of GDMT, which may lead to improved patient care and outcomes.

Eligibility

Min Age: 18 Years

Inclusion Criteria2

Ejection fraction (EF) less than or equal to 40% by echocardiogram performed in the prior 18 months
Diagnosis of heart failure

Exclusion Criteria4

Heart failure (HF) etiology for which GDMT is not indicated: including hypertrophic or restrictive cardiomyopathy (e.g. amyloid cardiomyopathy), constrictive pericarditis, or complex congenital heart disease
End-stage HF requiring continuous inotrope infusion, heart transplant, or left ventricular assist device
Estimated glomerular filtration rate (eGFR) \< 15 mL/min/1.73m\^2
Any conditions other than HF that are likely to alter the patient's status over 6 months, indicated by active hospice status

Interventions

BEHAVIORALOptimized version of the EPIC-HF Checklist

The EPIC-HF checklist is a 1-page patient activation tool that contains approved and guideline-recommended medications and target doses for HFrEF. The EPIC-HF checklist allows patients to see recommended doses and categories of GDMT, which they can compare to their current medications and dosing. The EPIC-HF checklist has been refined and updated to include GDMT prescription and has been optimized for delivery through electronic medical record (EMR) systems. The checklist is being used as a patient activation/ discussion tool only and data entered on the checklist will not be collected for purposes of this study.

BEHAVIORALClinician-facing Decision Support

Information regarding GDMT (including target doses and medications) analogous to what is contained in the checklist will be provided to clinicians in intervention clinics. This information will be visible at the time of the encounter.

BEHAVIORALStandard of Care

Patients of clinics that are not implementing EPIC-HF checklist will not have the checklist available to them through the electronic medical record (EMR).