Finding Heart Failure in Those Prescribed Loop Diuretics in Primary Care in Jersey (FIND HF LOOP)

Government of Jersey

Status: Invitation-only

Conditions: Diuretics; Heart Failure

Treatments: Diagnostic Test: NT-proBNP screening

Study type: Interventional

Funder types: Other

Identifiers

NCT07320677

2025HCJREC03

Details and patient eligibility

About

The goal of this clinical trial is to learn whether a simple blood test screening pathway can help diagnose heart failure earlier in adults in primary care who take loop diuretic medicines (such as furosemide or bumetanide) but do not have a recorded diagnosis of heart failure.

The main questions it aims to answer are:

1. Does offering a NT-proBNP blood test to eligible patients increase the number of new heart failure diagnoses within 12 months compared with usual care?
2. Does this screening pathway also uncover other important heart problems, such as irregular heart rhythms (arrhythmias) or valve disease?

This is a cluster randomised controlled trial, which means that whole GP practices, rather than individual patients, are randomly assigned to one of two approaches:

1. NT-proBNP screening pathway, in which eligible patients are invited for a NT-proBNP blood test
2. Usual care, in which patients continue to be managed as they normally would without proactive screening

Participants will:

Be identified from GP records if they are prescribed loop diuretics and have no prior diagnosis of heart failure

In screening practices, be invited to attend for a free finger-prick NT-proBNP blood test and brief questionnaire

Be referred to the heart failure team and invited for an echocardiogram (a heart ultrasound scan) and further assessment if their NT-proBNP level is higher than 125 pg/mL

Researchers will compare outcomes between screening and usual-care practices after 12 months, focusing on new diagnoses of heart failure. They will also look at other important cardiovascular findings, such as new arrhythmias, valve disease, and heart failure hospitalisation rates.

Enrollment: 400 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Receiving a loop diuretic (furosemide, bumetanide or torsemide)
• No coded diagnosis of heart failure in GP records
• Never had a natriuretic peptide test
• Willing to have a blood test for NT-proBNP

Exclusion criteria

• Clinical Frailty Score 7 or above on Rockwood frailty scale
• Prior diagnosis of heart failure
• Prior natriuretic peptide testing

Trial design

Primary purpose: Diagnostic

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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400 participants in 2 patient groups

Intervention - NTproBNP Screening

Experimental group

Description:

Half of the island's GP surgeries will be randomly allocated to the intervention arm, whereby patients receiving a loop diuretic but without a diagnosis of heart failure or natriuretic peptide testing will be invited for a point of care NT-proBNP test.

Treatment:

Diagnostic Test: NT-proBNP screening

Control - Usual care

No Intervention group

Description:

Half of the island's GP surgeries will be randomly allocated to the control arm, whereby patients will continue with usual clinical care and won't be approached by the study team.