Clinical trial NCT05986695: Informational Nudge to Improve Heart Failure Prescribing
Official title: Preliminary Implementation of an Informational Nudge to Improve Heart Failure Prescribing
Study type: INTERVENTIONAL
Overall status: ACTIVE_NOT_RECRUITING
Phase: NA
Conditions: Heart Failure
Keywords: Sodium-Glucose Transporter 2 Inhibitors
Mineralocorticoid Receptor Antagonists
Economics, Behavioral
feedback
medical audit
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
Collaborators: name: Arizona State University
First posted: 2023-08-14
Enrollment: 89
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: FACTORIAL
Intervention model description: This is a type 3 hybrid (implementation focused), four group, pragmatic trial of cardiology and primary care clinicians at a single VA medical center. The trial will include a 3-month preintervention period and 3-month intervention period. Clinicians will be randomized to one of four arms: usual care, informational alert, peer comparison feedback, and combination of alert and peer comparison.
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: This study addresses a critical gap of care for Veterans with heart failure (HF). Only 1/3 or fewer eligible Veterans are receiving recommended SGLT2 and MRA therapies that save lives and prevents HF hospitalizations. The investigators will compare the effect of clinician directed nudges as strategies to improve the health of Veterans with HF.

Detailed description: This study addresses a critical gap in quality of care for Veterans with heart failure (HF). Only 1/3 or fewer eligible Veterans are receiving SGLT2 inhibitors and mineralocorticoid receptor antagonists, both medications that save lives and prevents HF hospitalizations. The investigators will combine insights from behavioral science and quality improvement science to create two types of 'nudges' - informational alerts and peer comparison feedback - to increase prescribing of these medications. The investigators will create two types of 'nudges' - informational alerts and peer comparison feedback - to increase prescribing of these medications. The investigators will compare the effect of these two nudge strategies alone and in combination compared to usual care. This project will develop simple, scalable, and low-cost strategies to improve the health of Veterans with HF.

Eligibility criteria: Inclusion Criteria:

* Primary care and cardiology clinicians at Southern AZ VA Health Care System working in outpatient clinic setting

Exclusion Criteria:

* Clinicians who are in training status (resident, fellow) will be excluded.

Primary outcomes:
measure: Effectiveness
timeFrame: 30 days
Secondary outcomes:
measure: Reach-Clinician
timeFrame: 6 months
measure: Incidence of Treatment Emergent Adverse Events
timeFrame: 30 days
measure: Implementation-Acceptability
timeFrame: 6 months
measure: Reach-Patient
timeFrame: 6 months
measure: Reach-Comparison of Strategies
timeFrame: 6 months
measure: Implementation-Appropriateness
timeFrame: 6 months
measure: Implementation-Feasibility
timeFrame: 6 months
Other outcomes:
Locations:
city: Tucson
country: United States
facility: Southern Arizona VA Health Care System, Tucson, AZ
state: Arizona
Study officials:
affiliation: Southern Arizona VA Health Care System, Tucson, AZ
name: Sandesh Dev, MD
role: PRINCIPAL_INVESTIGATOR
References: