Heart Failure Clinical Trial

Email Nudges to Improve GDMT (MRA) Adherence in Heart Failure

Summary

The Email Nudges to Improve GDMT (MRA) Adherence in Heart Failure (ENIGMA-HF) study is a pragmatic parallel-arm randomized control trial of a quality improvement (QI) intervention involving email nudges to cardiology clinic managers to schedule appointments specific to guideline directed medical therapy (GDMT) initiation, with the goal of optimizing mineralocorticoid-receptor antagonist (MRA) use by patients with heart failure with reduced ejection fraction (HFrEF) cared for by cardiologists within the University of California, Los Angeles (UCLA) Health System.

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Full Description

Importance: Guideline directed medical therapy (GDMT) is a specific set of 4 medications proven to improve morbidity and mortality for patients with heart failure (HF) with reduced ejection fraction (HFrEF), yet they are underutilized nationally and internationally. Various quality improvement (QI) interventions have had varying degrees of success at increasing GDMT prescription and titration.

Objective: The purpose of the study is to assess whether email nudges to UCLA Health cardiology clinic managers to schedule GDMT-specific appointments can lead to increased utilization of a specific medication within GDMT called a mineralocorticoid-receptor antagonist (MRA). Pertinent secondary objectives will include evaluating whether email nudges specific to MRA would increase utilization of the other medications in GDMT and whether they would increase appointments specific to GDMT.

Design, Setting, and Participants: The basic design is a pragmatic parallel-arm randomized control trial of a QI intervention. The setting is cardiology outpatient clinics at a large university-based single integrated healthcare system (UCLA Health). Participants are outpatients with HFrEF under the care of a UCLA cardiologist, with an ejection fraction on file, and currently not prescribed an MRA.

Hypothesis: The investigators hypothesize that the intervention will lead to an increased utilization of MRA, compared to the control arm.

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Eligibility Criteria

Inclusion Criteria:

Facility: UCLA Health System
Patient is 18 years of age or older
Patient is under the care of a UCLA cardiologist
Patient has a primary diagnosis of HFrEF
Patient is not currently prescribed an MRA

Exclusion Criteria:

Hyperkalemia
Chronic kidney disease stage 4 or higher
Pregnant or breastfeeding patients
Heart transplant or ventricular-assist device patients
Hospice patients
Patients without an LVEF on file
Patients with an EF >35%

Study is for people with:

Heart Failure

Study ID:

NCT05806970

Recruitment Status:

Withdrawn

Sponsor:

University of California, Los Angeles

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There is 1 Location for this study

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University of California, Los Angeles
Los Angeles California, 90095, United States

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Study is for people with:

Heart Failure

Study ID:

NCT05806970

Recruitment Status:

Withdrawn

Sponsor:


University of California, Los Angeles

How clear is this clinincal trial information?

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