학술논문

The design of the Dashboard Activated Services and Telehealth for Heart Failure (DASH-HF) study: A pragmatic quality improvement randomized implementation trial for patients with heart failure with reduced ejection fraction
Document Type
article
Source
Subject
Health Services and Systems
Health Sciences
Heart Disease
Clinical Research
Cardiovascular
Prevention
Health Services
Clinical Trials and Supportive Activities
Good Health and Well Being
Heart Failure
Hospitalization
Humans
Quality Improvement
Stroke Volume
Telemedicine
Heart failure
Guideline -directed medical treatment
Quality improvement
Guideline-directed medical treatment
Medical and Health Sciences
General Clinical Medicine
Public Health
Biomedical and clinical sciences
Health sciences
Language
Abstract
BackgroundGaps in the receipt and dosing of guideline-directed medical therapy (GDMT) persist for patients with heart failure with reduced ejection fraction (HFrEF) [1]. In 2020, the Veterans Affairs (VA) developed a heart failure (HF) specific population dashboard to monitor care quality and performance on standard HFrEF performance measures [2].MethodsThe Dashboard Activated Services and Telehealth for HF (DASH-HF) study is a pragmatic randomized quality improvement study designed to evaluate the utility of proactive population management clinics using the VA's HF dashboard to optimize GDMT for patients with HFrEF. Panel management telemedicine clinics incorporated multidisciplinary clinicians to perform chart review and impromptu telephone encounters to evaluate current HFrEF management and opportunities to optimize GDMT. The study will evaluate the efficacy of proactive panel management to usual care at 6 months as quantified by the GDMT optimization potential score. Secondary outcomes include hospitalizations, mortality, and clinician time per intervention. The study completed enrollment and randomization of 300 participants. The intervention was performed from September to December 2021.ConclusionDASH-HF will contribute to the literature by evaluating use of the existing VA dashboard to identify HF patients with the lowest adherence to GDMT and proactively target this group for the intervention.Registrationhttps://clinicaltrials.gov/. Unique identifier: NCT05001165.