This is a prospective cohort study, where the investigators aim to investigate the effect of implementation of an electronic nudge alerting clinicians to the prescription of the 4 key pharmacological classes for the treatment of patients with heart failure and reduced ejection fraction (HFrEF) at the outpatient clinic in the Netherlands.
Study Type
OBSERVATIONAL
Enrollment
900
An algorithm will check if the patients if the patient has an age \>18 year and is treated at the cardiology department for HFrEF. The use of GDMT is determined using prescriptions data electronic health records (EHR). If the patient does not receive treatment for all 4 drug classes (ACE/ARB/ARNi, beta-blocker, MRA, SGLT2-inhibitor), an electronic alert will be displayed suggesting the clinician to prescribe additional medication when clinically indicated, including relevant recent laboratory results (renal function and electrolytes) and other relevant measures (LVEF, blood pressure and heart rate). The alert is linked to an order set to aid in the prescription of GDMT according to current guidelines. Results will compared to a retrospective cohort (t=-12 to t=-6) months, and a silent mode cohort (t=-6 to t=0 months, in which a paired and a before and after analysis will be performed to evaluate the effect of the alert.
Amsterdam University Medical Centers, Location AMC
Amsterdam, Netherlands
RECRUITINGAmsterdam University Medical Centers, Location VU Medical Center
Amsterdam, Netherlands
RECRUITINGUse of guideline-directed medical therapy (GDMT)
Using all therapies according to ESC guidelines
Time frame: 30 days (primary), 6 months (secondary)
All-cause mortality
All-cause mortality
Time frame: 1 year
Hospitalisation for Heart Failure
Hospitalisation for Heart Failure
Time frame: 6 months, 1 year
other major cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, non-fatal stroke)
other major cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, non-fatal stroke)
Time frame: 6 months, 1 year
renal events (>30% serum creatinine increase, hospitalization for acute kidney injury, development of end-stage kidney disease)
renal events (\>30% serum creatinine increase, hospitalization for acute kidney injury, development of end-stage kidney disease)
Time frame: 30 days, 6 months, 1 year
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