The patient engagement program for heart failure patients improved outcomes

A new patient engagement tool has led one in five heart failure patients to a more effective treatment regimen than generics, according to recent research presented today at the American Heart Association’s 2020 scientific sessions. The meeting is virtual, Friday 13 November – Tuesday 17 November 2020, and is a first-rate global exchange of the latest scientific advances, research and evidence-based clinical practice updates in cardiovascular science for healthcare. The manuscript of this study is published simultaneously today in Circulation, the flagship magazine of the American Heart Association.

In the study “Electronically Provided Patient Activation Tool for Drug Intensification for Chronic Heart Failure with Reduced Ejection Fraction: The EPIC-HF Study”, patients were randomized into two groups: those who had a clinic visit of regularly scheduled cardiology than those who received an additional involvement and training tool before the visit. Patients assigned to the patient engagement tool, called EPIC-HF, received access to a three-minute video and one-page checklist, delivered electronically via text or email, one week, three days, and 24 hours prior to a cardiology clinic visit.

Heart failure patients with reduced ejection fraction (HFrEF) have a weak left ventricle, so the body receives less blood than it needs. Multiple drugs have been shown to improve heart function, and when used in conjunction with doses that can help them meet treatment goals, these medicines can help people with HFrEF feel better, live longer, and improve their condition. Unfortunately, most people with HFrEF don’t get all their medications at the right doses. Often, those prescribed are too low in dosage.

EPIC-HF’s goal was to help patients understand their treatment options and encourage them to collaborate with their healthcare professionals to “make a positive change” to their HFrEF treatment.

The research analyzed the results of 290 patients, half of whom received the patient’s EPIC-HF educational tools. The mean age of the patients was 65 years and 29% were female. The mean left ventricular ejection fraction was 32%. At the start of the study, none of the 290 patients were receiving optimal HFrEF treatment (the current standard of care for HFrEF includes target doses of a beta-blocker; sacubitril / valsartan; and spironolactone or eplerenone).

The study results show:

• Almost half (49%) of the EPIC-HF intervention group had a change in medication for HFrEF to improve therapy compared with 29.7% in the control group.
• Most of the changes were increases in doses of HFrEF generics already prescribed, not new drugs.
• The increase in drug doses caused no obvious problems in the 30 days following the clinic visit.

“We are pleasantly surprised that this fairly simple tool has led so many patients to better care. It is promising that patients have been able to get better treatment,” said study lead author Larry A. Allen, MD, MHS. , chief of the associate division for clinical affairs in cardiology and co-director of the Colorado Program for Patient-Centered Decision at the University of Colorado School of Medicine in Aurora, Colorado. “This approach validates and fosters a culture of collaboration between patients and their physicians and leads to more productive clinical visits with optimized drug prescription, which can ultimately improve patient outcomes.”

Researchers believe patient-centric tools that inform and encourage people to become active participants in their health will improve overall care and outcomes.