A randomized, single-blind intervention trial to test the comparative effectiveness of an electronic health record best practice advisory system that informs clinicians of guideline-indicated and FDA-approved heart failure medications currently not prescribed to their patients with heart failure versus usual care (no alert and how things are done currently). The purpose of the alert is to stimulate appropriate medication prescription for patients with heart failure and a reduced ejection fraction. This will be done across outpatient Inova clinics and at the five Inova hospitals.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
5,000
Providers caring for patients randomized to the intervention arm will have a best practice alert appear for each of their eligible patients upon opening of the order entry screen in the patient's medical record. This alert informs the provider to the presence of HFrEF, notes the patient's current LVEF and current evidence-based medications, and gives access to an order set with recommended evidence- based, guideline-recommended, and FDA- approved therapies for patients with HFrEF. Providers will also have access to a link to best available guideline recommended information regarding treatment of heart failure to allow further education if desired by the provider. The alerts will also clearly state the expected monitoring and follow-up required for prescriptions of these medications.
Inova Health System
Falls Church, Virginia, United States
RECRUITINGIncreased use of GDMT in patients with Heart Failure with Reduced Ejection Fraction
The primary outcome for the trial will be the proportion of patients with HFrEF who have an increase in the number of prescribed evidence-based therapies for HFrEF (beta-blockers, ACE-I/ARB/ARNI, MRA, SGLT2i) 30 days after randomization.
Time frame: 30 days after randomization
All-cause hospitalization and all-cause mortality at 30 days
Outcomes will be determined by review of medical, hospital, and billing records.
Time frame: 30 days
All-cause hospitalization and all-cause mortality at 90 days
Outcomes will be determined by review of medical, hospital, and billing records.
Time frame: 90 days
All-cause hospitalization and all-cause mortality at 180 days
Outcomes will be determined by review of medical, hospital, and billing records.
Time frame: 180 days
All-cause hospitalization and all-cause mortality at 1 year
Outcomes will be determined by review of medical, hospital, and billing records.
Time frame: 1 year
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