Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.
Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America.
Contemp Clin Trials. 2022 Sep;120:106895. doi: 10.1016/j.cct.2022.106895. Epub 2022 Aug 24.
Gaps in the receipt and dosing of guideline-directed medical therapy (GDMT) persist for patients with heart failure with reduced ejection fraction (HFrEF) [1]. In 2020, the Veterans Affairs (VA) developed a heart failure (HF) specific population dashboard to monitor care quality and performance on standard HFrEF performance measures [2].
The Dashboard Activated Services and Telehealth for HF (DASH-HF) study is a pragmatic randomized quality improvement study designed to evaluate the utility of proactive population management clinics using the VA's HF dashboard to optimize GDMT for patients with HFrEF. Panel management telemedicine clinics incorporated multidisciplinary clinicians to perform chart review and impromptu telephone encounters to evaluate current HFrEF management and opportunities to optimize GDMT. The study will evaluate the efficacy of proactive panel management to usual care at 6 months as quantified by the GDMT optimization potential score. Secondary outcomes include hospitalizations, mortality, and clinician time per intervention. The study completed enrollment and randomization of 300 participants. The intervention was performed from September to December 2021.
DASH-HF will contribute to the literature by evaluating use of the existing VA dashboard to identify HF patients with the lowest adherence to GDMT and proactively target this group for the intervention.
https://clinicaltrials.gov/. Unique identifier: NCT05001165.
对于射血分数降低的心力衰竭（HFrEF）患者，指南指导的医学治疗（GDMT）的接受和剂量仍存在差距[1]。2020 年，退伍军人事务部（VA）开发了一种心力衰竭（HF）专用人群仪表板，以监测标准 HFrEF 绩效指标的护理质量和绩效[2]。
Dashboard Activated Services and Telehealth for HF（DASH-HF）研究是一项实用的随机质量改进研究，旨在评估使用 VA 的 HF 仪表板主动进行人群管理诊所的效用，以优化 HFrEF 患者的 GDMT。小组管理远程医疗诊所纳入多学科临床医生进行图表审查和临时电话访问，以评估当前 HFrEF 管理和优化 GDMT 的机会。该研究将通过 GDMT 优化潜力评分评估主动小组管理对常规护理的 6 个月疗效。次要结局包括住院、死亡和每位干预者的临床医生时间。该研究完成了 300 名参与者的入组和随机分组。干预于 2021 年 9 月至 12 月进行。
DASH-HF 将通过评估使用现有的 VA 仪表板来识别 GDMT 依从性最低的 HF 患者并主动针对该组进行干预，为文献做出贡献。
