The overall objective of the proposed pilot study is to begin evaluation of two methods for promoting adherence to guidelines for beta-blocker therapy in heart failure. The design includes site level baseline measurement, feedback, remeasurement after six months, and randomized (by site) comparison samples. The setting is VA sites, with intervention directed at the pharmacy.
Current evidence-based guidelines in VA recommend one of three beta-blockers (carvedilol, metoprolol succinate, or bisoprolol) that have been shown to reduce mortality in heart failure patients with systolic dysfunction, with recommended target doses. However, Pharmacy Benefits Management (PBM) data indicate that prescribing for beta-blockers in heart failure patients that is not in accordance with guidelines is substantial, both in terms of the agent selected and the dose. Sites will be recruited and randomized to two different intensities of intervention to promote adherence to guidelines.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
220
provide site-specific information on non-adherence to guideline
provide site-specific information on non-adherence to guideline as well as list of patients with non-adherent prescriptions
Edward Hines Jr. VA Hospital, Hines, IL
Hines, Illinois, United States
Rate of Adherence to Guideline Prescription
full adherence to guideline medication and dose
Time frame: 6 months
Progress Toward Adherence to Guideline Prescription
either change to a guideline agent or dose increase of a guideline agent
Time frame: 6 months
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