Research article
Virtual Care Team Guided Management of Patients With Heart Failure During Hospitalization
- Implementation trial
- multicentre
- 3 centres in an integrated health system
Authors' conclusion
Among patients hospitalized with HFrEF, a virtual care team guided strategy for GDMT optimization was safe and improved GDMT across multiple hospitals in an integrated health system.
Study context
- Population
- Hospitalized patients with heart failure with reduced ejection fraction (HFrEF) (LVEF ≤40%)
- Participants
- 252 hospital encounters
- Comparison
- Virtual care team guided strategy vs usual care for guideline-directed medical therapy (GDMT) optimization
- Virtual care teamn = 107 encounters among 83 patients
- Usual caren = 145 encounters among 115 patientsreference
- Outcome
- In-hospital change in GDMT optimization score (+2 initiations, +1 dose up-titrations, −1 dose down-titrations, −2 discontinuations summed across classes)
- Follow-up
- In-hospital
Main finding
GDMT optimization score
Adjusted difference
+1.2
95% CI 0.7–1.8
P < 0.001
As reported in the abstract
Further findings
New initiations during hospitalization
absolute difference +21% · P = 0.001
Net intensifications during hospitalization
absolute difference +20% · P = 0.002
- Net intensifications during hospitalization — Number needed to intervene
- 5 encounters
Safety
≥1 adverse event · in-hospital · adjudicated by an independent clinical events committee
P = 0.30
AKI, bradycardia, hypotension, hyperkalemia, length of stay
- Similar between groups
Original publication
Virtual Care Team Guided Management of Patients With Heart Failure During Hospitalization. J Am Coll Cardiol. Published 6 March 2023. doi:10.1016/j.jacc.2023.02.029
Summarised from the published abstract; every number is checked against it