Clinical Reminders in Test Reports to Improve Guideline Compliance
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Although beta-blockers are known to prolong survival for patients with reduced left ventricular ejection fraction, their use in the community and the VA is suboptimal.
Full description
Background:
Although beta-blockers are known to prolong survival for patients with reduced left ventricular ejection fraction, their use in the community and the VA is suboptimal.
Objectives:
To determine if a reminder attached to the echocardiography report would increase the use of beta-blockers among patients with depressed left ventricular function.
Methods:
We are randomizing consecutive patients undergoing echocardiography at one of three VA echocardiography laboratories with reduced left ventricular ejection fraction (<40%) and no echocardiographic contraindication to beta-blockers (e.g. aortic stenosis) to a reminder for use of beta-blockers or to no reminder. The reminder gives starting doses for two commonly used beta-blockers (carvedilol and metoprolol). Patients are excluded from the analysis if they leave the health care system or die within three months of randomization. The primary outcome is a prescription for a beta-blocker between three and nine months following echocardiography
Status:
The project is complete.
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Inclusion criteria
Those undergoing echocardiography at one of the participating laboratories with an ejection fraction < 45%.
Exclusion criteria
aortic stenosis, mitral stenosis
Trial design
1,500 participants in 1 patient group
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Data sourced from clinicaltrials.gov
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