P rimary care A dherence T o H eart F ailure guidelines IN D iagnosis, E valuation and R outine management (PATHFINDER): a randomised controlled trial protocol.

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Tytuł:: P rimary care A dherence T o H eart F ailure guidelines IN D iagnosis, E valuation and R outine management (PATHFINDER): a randomised controlled trial protocol.
Autorzy:: Dai L; Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.
Dorje T; Department of Cardiology, Mount Hospital, Perth, Western Australia, Australia.; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia.; Department of Cardiology, Joondalup Health Campus, Joondalup, Western Australia, Australia.
Gootjes J; WA Cardiology, Perth, Western Australia, Australia.
Shah A; Department of Cardiology and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Dembo L; Department of Cardiology and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Rankin J; Department of Cardiology and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Hillis G; Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia.; Medical School, The University of Western Australia, Perth, Western Australia, Australia.
Robinson S; Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.; Deakin Health Economics, Deakin University, Melbourne, Western Australia, Australia.
Atherton JJ; Department of Cardiology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.; Faculty of Medicine, The University of Queensland, Saint Lucia, Queensland, Australia.
Jacques A; Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.; Institute for Health Research, The University of Notre Dame, Fremantle, Western Australia, Australia.
Reid CM; Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Maiorana A; Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia .; Department of Allied Health, Fiona Stanley Hospital, Murdoch, Western Australia, Australia.
Źródło:: BMJ open [BMJ Open] 2023 Mar 27; Vol. 13 (3), pp. e063656. Date of Electronic Publication: 2023 Mar 27.
Typ publikacji:: Clinical Trial Protocol; Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
MeSH Terms:: Heart Failure*/diagnosis
Heart Failure*/drug therapy
Cardiac Rehabilitation*
Humans ; Quality of Life ; Self Care/methods ; Primary Health Care ; Randomized Controlled Trials as Topic ; Multicenter Studies as Topic
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Contributed Indexing:: Keywords: Clinical trials; Heart failure; PRIMARY CARE
Entry Date(s):: Date Created: 20230327 Date Completed: 20230329 Latest Revision: 20230919
Update Code:: 20240104
PubMed Central ID:: PMC10069547
DOI:: 10.1136/bmjopen-2022-063656
PMID:: 36972959
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Introduction: General practitioners (GPs) routinely provide care for patients with heart failure (HF); however, adherence to management guidelines, including titrating medication to optimal dose, can be challenging in this setting. This study will evaluate the effectiveness of a multifaceted intervention to support adherence to HF management guidelines in primary care.
Methods and Analysis: We will undertake a multicentre, parallel-group, randomised controlled trial of 200 participants with HF with reduced ejection fraction. Participants will be recruited during a hospital admission due to HF. Following hospital discharge, the intervention group will have follow-up with their GP scheduled at 1 week, 4 weeks and 3 months with the provision of a medication titration plan approved by a specialist HF cardiologist. The control group will receive usual care. The primary endpoint, assessed at 6 months, will be the difference between groups in the proportion of participants being prescribed five guideline-recommended treatments; (1) ACE inhibitor/angiotensin receptor blocker/angiotensin receptor neprilysin inhibitor at least 50% of target dose, (2) beta-blocker at least 50% of target dose, (3) mineralocorticoid receptor antagonist at any dose, (4) anticoagulation for patients diagnosed with atrial fibrillation, (5) referral to cardiac rehabilitation. Secondary outcomes will include functional capacity (6-minute walk test); quality of life (Kansas City Cardiomyopathy Questionnaire); depressive symptoms (Patient Health Questionnaire-2); self-care behaviour (Self-Care of Heart Failure Index). Resource utilisation will also be assessed.
Ethics and Dissemination: Ethical approval was granted by the South Metropolitan Health Service Ethics Committee (RGS3531), with reciprocal approval at Curtin University (HRE2020-0322). Results will be disseminated via peer-reviewed publications and conferences.
Trial Registration Number: ACTRN12620001069943.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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