Strategies to Improve Prescribing in Heart Failure Patients

Niguarda Hospital

Status: Terminated

Conditions: Chronic Heart Failure

Treatments: Other: Usual care; Other: Strategy for assisted uptitration

Study type: Interventional

Funder types: Other

Identifiers

NCT01023438

SMART SC

Details and patient eligibility

About

The purpose of the study is to assess whether primary care physicians may uptitrate recommended drug therapies in stable heart failure patients if educational material and specialist support including phone or mail consultation are provided

Full description

Heart failure is highly prevalent, particularly in elderly subjects, and costly, mainly because of the high rate of recurrent hospital admissions. Although guideline-recommended treatments, such as beta-blockers and renin-angiotensin inhibitors, are effective on both mortality and morbidity, these drugs are very often underprescribed or used at lower doses than those shown to be beneficial in clinical trials, particularly in the primary care setting, for fear of adverse events. Although referral to specialist services may improve prescription of recommended drugs and doses achieved, frequent consultations may be unfeasible and costly.The study is designed to assess whether active specialist support and educational material improve the prescription process for heart failure patients in primary care

Enrollment: 30 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• a confirmed diagnosis of heart failure wih depressed systolic function (left ventricular ejection fraction <40% in the previous 6 months).
• stable NYHA class II-III
• a clinical indication to implement drug therapy with betablockers and/or renin-angiotensin system inhibitors and current dose <50% of the target dose

Exclusion criteria

• NYHA class IV or clinically unstable
• cardiac surgery or cardiac resynchronization therapy planned within the following 6 months
• discharged to a rehabilitation unit refusal or impossibility to present to outpatient visits

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

Assisted uptitration

Experimental group

Description:

Uptitration of recommended drugs by primary care physician with specialist support

Treatment:

Other: Strategy for assisted uptitration

Usual care

Active Comparator group

Description:

Usual communication strategy from cardiologist to primary care physician

Treatment:

Other: Usual care