Primary care Adherence To Heart Failure guidelines IN Diagnosis, Evaluation and Routine management (PATHFINDER): A randomised controlled trial protocol
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 interven...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
| Published: |
2023
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/93102 |
| _version_ | 1848765698257453056 |
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| author | Dai, L. Dorje, T. Gootjes, J. Shah, A. Dembo, L. Rankin, J. Hillis, G. Robinson, Suzanne Atherton, J.J. Jacques, Angela Reid, Christopher Maiorana, Andrew |
| author_facet | Dai, L. Dorje, T. Gootjes, J. Shah, A. Dembo, L. Rankin, J. Hillis, G. Robinson, Suzanne Atherton, J.J. Jacques, Angela Reid, Christopher Maiorana, Andrew |
| author_sort | Dai, L. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | 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. |
| first_indexed | 2025-11-14T11:39:23Z |
| format | Journal Article |
| id | curtin-20.500.11937-93102 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:39:23Z |
| publishDate | 2023 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-931022023-09-19T01:17:08Z Primary care Adherence To Heart Failure guidelines IN Diagnosis, Evaluation and Routine management (PATHFINDER): A randomised controlled trial protocol Dai, L. Dorje, T. Gootjes, J. Shah, A. Dembo, L. Rankin, J. Hillis, G. Robinson, Suzanne Atherton, J.J. Jacques, Angela Reid, Christopher Maiorana, Andrew Clinical trials Heart failure PRIMARY CARE Humans Quality of Life Heart Failure Cardiac Rehabilitation Self Care Primary Health Care Randomized Controlled Trials as Topic Multicenter Studies as Topic Humans Self Care Quality of Life Primary Health Care Heart Failure Multicenter Studies as Topic Randomized Controlled Trials as Topic Cardiac Rehabilitation 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. 2023 Journal Article http://hdl.handle.net/20.500.11937/93102 10.1136/bmjopen-2022-063656 eng http://purl.org/au-research/grants/nhmrc/1136372 http://creativecommons.org/licenses/by-nc/4.0/ fulltext |
| spellingShingle | Clinical trials Heart failure PRIMARY CARE Humans Quality of Life Heart Failure Cardiac Rehabilitation Self Care Primary Health Care Randomized Controlled Trials as Topic Multicenter Studies as Topic Humans Self Care Quality of Life Primary Health Care Heart Failure Multicenter Studies as Topic Randomized Controlled Trials as Topic Cardiac Rehabilitation Dai, L. Dorje, T. Gootjes, J. Shah, A. Dembo, L. Rankin, J. Hillis, G. Robinson, Suzanne Atherton, J.J. Jacques, Angela Reid, Christopher Maiorana, Andrew Primary care Adherence To Heart Failure guidelines IN Diagnosis, Evaluation and Routine management (PATHFINDER): A randomised controlled trial protocol |
| title | Primary care Adherence To Heart Failure guidelines IN Diagnosis, Evaluation and Routine management (PATHFINDER): A randomised controlled trial protocol |
| title_full | Primary care Adherence To Heart Failure guidelines IN Diagnosis, Evaluation and Routine management (PATHFINDER): A randomised controlled trial protocol |
| title_fullStr | Primary care Adherence To Heart Failure guidelines IN Diagnosis, Evaluation and Routine management (PATHFINDER): A randomised controlled trial protocol |
| title_full_unstemmed | Primary care Adherence To Heart Failure guidelines IN Diagnosis, Evaluation and Routine management (PATHFINDER): A randomised controlled trial protocol |
| title_short | Primary care Adherence To Heart Failure guidelines IN Diagnosis, Evaluation and Routine management (PATHFINDER): A randomised controlled trial protocol |
| title_sort | primary care adherence to heart failure guidelines in diagnosis, evaluation and routine management (pathfinder): a randomised controlled trial protocol |
| topic | Clinical trials Heart failure PRIMARY CARE Humans Quality of Life Heart Failure Cardiac Rehabilitation Self Care Primary Health Care Randomized Controlled Trials as Topic Multicenter Studies as Topic Humans Self Care Quality of Life Primary Health Care Heart Failure Multicenter Studies as Topic Randomized Controlled Trials as Topic Cardiac Rehabilitation |
| url | http://purl.org/au-research/grants/nhmrc/1136372 http://hdl.handle.net/20.500.11937/93102 |