N/A
N=300
Dashboard Activated Services and Tele-Health for Heart Failure
Heart Failure With Reduced Ejection Fraction
Bottom Line
View on ClinicalTrials.gov: NCT05001165 ↗Enrolled (actual)
300
Serious AEs
27.0%
Results posted
Nov 2024
Primary outcome: Primary: Optimization Potential Score — 2.9; 2.6 score on a scale
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Proactive Panel Management Clinics for HFrEF (Other)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- VA Greater Los Angeles Healthcare System
- Primary completion
- Jun 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Optimization Potential Score |
2.9; 2.6 | — |
| SECONDARY Change in Number of Patient Receiving ACE/ARB/ARNI |
97; 86 | — |
| SECONDARY Change in the Number of Patients Receiving Beta-blockers |
109; 107 | <0.05 sig |
| SECONDARY Change in the Number of Patients Receiving MRA |
53; 47 | — |
| SECONDARY Change in Number of Patients Receiving ARNI |
35; 31 | — |
| SECONDARY Change in Number of Patients Receiving SGLT2i |
44; 33 | — |
| SECONDARY Total Number of Hospitalizations |
29; 17 | — |
| SECONDARY Change in Total Deaths |
17; 24 | — |
Summary
The Dashboard Activated Services and tele-Health for Heart Failure (DASH-HF) study is a pragmatic randomized controlled trial of a quality improvement (QI) intervention of a prospective panel management intervention to optimize medical treatment for Veterans with heart failure with reduced ejection fraction (HFrEF) compared to the receipt of usual VA health care services over a 6-month period of observation. The study will incorporate the existing VA Academic Detailing Heart Failure Dashboard (ADHFD) to target actionable patients with gaps in performance measures for guideline-directed medical therapies (GDMT). Patients with HFrEF are optimally managed by cardiovascular specialty clinics. Typically, patients are referred to cardiology or heart failure (HF) clinics from primary care, emergency department, or post-hospitalization clinicians and scheduled into clinic grids. These patients may be lost to follow-up or clinicians may miss opportunities to optimize GDMT for HFrEF. GDMT includes Class I indicated medications from the following classes: beta blockers (BB), angiotensin-converting enzyme inhibitor (ACE), angiotensin II receptor blockers (ARB), angiotensin receptor neprilysin inhibitor (ARNI), mineralocorticoid receptor antagonist (MRA), sodium-glucose cotransporter-2 inhibitor (SGLT2i). The intervention is designed around a novel prospective panel management clinic led by clinicians or clinical pharmacists using impromptu patient telephone calls or electronic communications with existing responsible clinicians.
Eligibility Criteria
Inclusion Criteria
- Facility: Greater Los Angeles, CA
- Division: West LA VAMC
- Patient is eighteen years of age or older
- Patients has a primary diagnosis of HFrEF (last documented LVEF ≤35% per ADHFD algorithms)
- Patient has an estimated GFR greater than or equal to 30 mL/min
- Patient has a last documented potassium less than 5
- Patient has a last documented systolic blood pressure over 90 mm Hg
- Patient lacks at least one active prescription of a beta-blocker, ACE/ARB/ARNI, MRA, or SGLT2i
- There are no upcoming heart failure or primary care appointments in the upcoming 2 weeks.
Exclusion Criteria
● Patient is currently hospitalized at WLA
Data sourced from ClinicalTrials.gov (NCT05001165). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.