Informational Nudge to Improve Heart Failure Prescribing

VA Office of Research and Development

Status: Active, not recruiting

Conditions: Heart Failure

Treatments: Behavioral: Peer comparison report; Behavioral: Alert

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT05986695

PPO 22-091

Details and patient eligibility

About

This study addresses a critical gap of care for Veterans with heart failure (HF). Only 1/3 or fewer eligible Veterans are receiving recommended SGLT2 and MRA therapies that save lives and prevents HF hospitalizations. The investigators will compare the effect of clinician directed nudges as strategies to improve the health of Veterans with HF.

Full description

This study addresses a critical gap in quality of care for Veterans with heart failure (HF). Only 1/3 or fewer eligible Veterans are receiving SGLT2 inhibitors and mineralocorticoid receptor antagonists, both medications that save lives and prevents HF hospitalizations. The investigators will combine insights from behavioral science and quality improvement science to create two types of 'nudges' - informational alerts and peer comparison feedback - to increase prescribing of these medications. The investigators will create two types of 'nudges' - informational alerts and peer comparison feedback - to increase prescribing of these medications. The investigators will compare the effect of these two nudge strategies alone and in combination compared to usual care. This project will develop simple, scalable, and low-cost strategies to improve the health of Veterans with HF.

Enrollment: 89 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Primary care and cardiology clinicians at Southern AZ VA Health Care System working in outpatient clinic setting

Exclusion criteria

• Clinicians who are in training status (resident, fellow) will be excluded.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

---

89 participants in 4 patient groups

Peer Comparison Report

Active Comparator group

Description:

Clinicians assigned to peer comparison, will receive messages by secure email every two weeks regarding their SGLT2i and MRA prescribing performance.

Treatment:

Behavioral: Peer comparison report

Alert

Active Comparator group

Description:

Clinicians in the alert arm will receive an alert two business days prior to a patient's upcoming appointment. Clinicians will receive approximately two alerts per week.

Treatment:

Behavioral: Alert

Alert and Peer Comparison

Active Comparator group

Description:

The combined alert and peer comparison arm will receive both interventions.

Treatment:

Behavioral: Alert

Behavioral: Peer comparison report

Control

No Intervention group

Description:

No alert or peer comparison