New Solutions to Support Evidence-Based Prescribing for Heart Failure
Keywords
Chronic disease prevention management; multiple chronic conditions
Types of Research
Dissemination and implementation research; practice based research
Summary
This study compares a traditional and clinician-personalized decision support (CDS) tools in a pragmatic randomized controlled trial. The clinician-personalized CDS uses historical prescribing data to address individual clinician misconceptions related to the suboptimal prescribing of medications for heart failure with reduced ejection fraction (HFrEF). In contrast, the traditional CDS displays information that addresses common clinician misconceptions. Dissemination and implementation science frameworks (PRISM/RE-AIM) guide the design and evaluation of the CDS.
Significance
This study strategically addresses misconceptions to GDMT by personalizing CDS to meet clinicians’ individualized informational needs; thereby, has the potential to improve prescribing of GDMT and outcomes for high-risk patients with HFrEF.
Impact
This study has the potential to substantially improve prescribing of GDMT and outcomes for high-risk patients with HFrEF. The results of this study will also provide methodological expertise to others who wish to use this approach to improve evidence-based prescribing for other disease states and across patient care settings.
Implications for Reducing Health Disparities
Most patients (>90%) with HFrEF do not receive GDMT (2–4). These medications reduce re-hospitalization, cardiovascular events and healthcare costs and have repeatedly demonstrated marked improvements in survival and quality of life. We aim to improve GDMT for HFrEF, specifically beta blockers, SGLT2is, MRAs, and sacubitril/valsartan.
Lessons Learned
The 6-month RCT across all UCHealth primary care and outpatient cardiology clinics has been completed as of 7/29/25.
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