Digital consults to optimize guideline‐directed therapy: design of a pragmatic multicenter randomized controlled trial DOI Creative Commons
Jelle P. Man, Marcel G. W. Dijkgraaf, M. Louis Handoko

и другие.

ESC Heart Failure, Год журнала: 2023, Номер 11(1), С. 560 - 569

Опубликована: Дек. 26, 2023

Many heart failure (HF) patients do not receive optimal guideline-directed medical therapy (GDMT) despite clear benefit on morbidity and mortality outcomes. Digital consults (DCs) have the potential to improve efficiency GDMT optimization serve growing HF population. The investigator-initiated ADMINISTER trial was designed as a pragmatic multicenter randomized controlled open-label evaluate efficacy safety of DC in treatment.

Язык: Английский

Digital solutions to optimize guideline-directed medical therapy prescription rates in patients with heart failure: a clinical consensus statement from the ESC Working Group on e-Cardiology, the Heart Failure Association of the European Society of Cardiology, the Association of Cardiovascular Nursing & Allied Professions of the European Society of Cardiology, the ESC Digital Health Committee, the ESC Council of Cardio-Oncology, and the ESC Patient Forum DOI Creative Commons
Mark J. Schuuring, Roderick W Treskes, Teresa Castiello

и другие.

European Heart Journal - Digital Health, Год журнала: 2024, Номер 5(6), С. 670 - 682

Опубликована: Авг. 30, 2024

Abstract The 2021 European Society of Cardiology guideline on diagnosis and treatment acute chronic heart failure (HF) the 2023 Focused Update include recommendations pharmacotherapy for patients with New York Heart Association (NYHA) class II–IV HF reduced ejection fraction. However, multinational data from EVOLUTION study found substantial prescribing inertia guideline-directed medical therapy (GDMT) in clinical practice. cause was multifactorial included limitations organizational resources. Digital solutions like digital consultation, remote monitoring, interrogation cardiac implantable electronic devices, decision support systems, multifaceted interventions are increasingly available worldwide. objectives this Clinical Consensus Statement to provide (i) examples that can aid optimization prescription GDMT, (ii) evidence-based insights GDMT using solutions, (iii) current evidence gaps implementation barriers limit adoption practice, (iv) critically discuss strategies achieve equality access, reference patient subgroups. Embracing through use consults monitoring will future-proof, example alerts clinicians, informing them suboptimal GDMT. Researchers should consider employing optimize effectiveness designs fit unique sociotechnical aspects solutions. Artificial intelligence handle larger sets relieve professionals’ workloads, but as artificial limited, further investigation is warranted.

Язык: Английский

Процитировано

8

Digital consults in heart failure care: a randomized controlled trial DOI Creative Commons
Jelle P. Man, M. A. C. Koole,

Paola G. Meregalli

и другие.

Nature Medicine, Год журнала: 2024, Номер unknown

Опубликована: Авг. 31, 2024

Abstract Guideline-directed medical therapy (GDMT) has clear benefits on morbidity and mortality in patients with heart failure; however, GDMT use remains low. In the multicenter, open-label, investigator-initiated ADMINISTER trial, ( n = 150) diagnosed failure reduced ejection fraction (HFrEF) were randomized (1:1) to receive usual care or a strategy using digital consults (DCs). DCs contained (1) data sharing from patient clinician (pharmacotherapy use, home-measured vital signs Kansas City Cardiomyopathy Questionnaires); (2) education via text-based e-learning; (3) guideline recommendations all treating clinicians. All remotely gathered information was processed into summary that available clinicians electronic health record before every consult. interactions standardly conducted remotely. The primary endpoint change score over 12 weeks (ΔGDMT); this directly incorporated non-conditional class 1 indications for HFrEF equal weights. trial met its outcome of achieving higher DC group after follow-up (ΔGDMT group: median 1.19, interquartile range (0.25, 2.3) arbitrary units versus 0.08 (0.00, 1.00) care; P < 0.001). To our knowledge, is first multicenter controlled proves effective achieve optimization. ClinicalTrials.gov registration: NCT05413447 .

Язык: Английский

Процитировано

6

Digital Solutions to Optimize Guideline-Directed Medical Therapy Prescriptions in Heart Failure Patients: Current Applications and Future Directions DOI Creative Commons
Jelle P. Man, Joanna E. Klopotowska, Folkert W. Asselbergs

и другие.

Current Heart Failure Reports, Год журнала: 2024, Номер 21(2), С. 147 - 161

Опубликована: Фев. 16, 2024

Abstract Purposeof Review Guideline-directed medical therapy (GDMT) underuse is common in heart failure (HF) patients. Digital solutions have the potential to support professionals optimize GDMT prescriptions a growing HF population. We aimed review current literature on effectiveness of digital optimization patients with HF. Recent Findings report efficacy, characteristics study, and population published for optimization. The following are discussed: teleconsultation, telemonitoring, cardiac implantable electronic devices, clinical decision embedded within health records, multifaceted interventions. Effect reported dedicated studies, retrospective or larger studies another focus that also commented use. Overall, we see more significant increase However, there large heterogeneity study design, outcomes used, populations studied, which hampers comparison different solutions. Barriers, facilitators, designs, future directions discussed. Summary There remains need well-designed evaluation determine safety Based this review, measuring controlling vital signs telemedicine should be encouraged, actively alerted about suboptimal GDMT, researchers consider employing effectiveness, use designs fit unique sociotechnical aspects Future expected include artificial intelligence handle datasets relieve professional’s workload.

Язык: Английский

Процитировано

4

Digital consults to optimize guideline‐directed therapy: design of a pragmatic multicenter randomized controlled trial DOI Creative Commons
Jelle P. Man, Marcel G. W. Dijkgraaf, M. Louis Handoko

и другие.

ESC Heart Failure, Год журнала: 2023, Номер 11(1), С. 560 - 569

Опубликована: Дек. 26, 2023

Many heart failure (HF) patients do not receive optimal guideline-directed medical therapy (GDMT) despite clear benefit on morbidity and mortality outcomes. Digital consults (DCs) have the potential to improve efficiency GDMT optimization serve growing HF population. The investigator-initiated ADMINISTER trial was designed as a pragmatic multicenter randomized controlled open-label evaluate efficacy safety of DC in treatment.

Язык: Английский

Процитировано

4