Pharmacist-Assisted Titration of Rx to Implement Optimal Medical Therapy for Heart Failure | NCT07714239

NCT07714239

Overview

NCT ID: NCT07714239
Lead Sponsor: VA Office of Research and DevelopmentFED
Official Title: Pharmacist-Assisted Titration of Rx to Implement Optimal Medical Therapy for Heart Failure (PATRIOT-HF) (QUE 25-018)
Brief Summary: Many Veterans who are hospitalized with heart failure do not receive all the recommended heart medications at the right doses before they leave the hospital or in the weeks following discharge. This study tests whether a team of clinical pharmacists and cardiologists, working virtually, can improve heart failure medication prescribing for Veterans at VA medical centers. The pharmacist and cardiologist team reviews patient records and provides recommendations to the treating doctors and primary care providers caring for Veterans with heart failure. The goal is to increase use of guideline-recommended medications, which have been shown to improve survival, reduce hospitalizations, and improve quality of life.
Conditions: Heart Failure

Status and Timeline

Status: Not yet recruiting
Last Update Posted: Jul 20, 2026Actual
Start Date: Jul 24, 2026Estimated
Primary Completion Date: Sep 30, 2030Estimated
Completion Date

Participation Criteria

Ages Eligible for Study: Adult (18-64)Older Adult (65+)
Sexes Eligible for Study: All
Accepts Healthy Volunteers?: No
Eligibility Criteria: Inclusion Criteria:

Admission to a VA medical center or VA-paid community hospital within the preceding 3 months with a primary diagnosis of heart failure

The primary study cohort will consist of those admitted to a VA medical center, while the secondary study cohort will consist of patients admitted to VA-paid community hospitals

Left ventricular ejection fraction ≤ 40%

Not on optimal guideline-directed heart failure medication classes or doses, as assessed in the electronic health record

Receiving care within one of the 6 participating VA medical centers

Exclusion Criteria:

Hemodynamic instability

Receiving comfort care measures alone or enrolled in hospice

Study Plan

Study Type: Interventional
Phase: Not Applicable
Enrollment: 585Estimated
Primary Purpose: Health Services Research
Allocation: Randomized
Interventional Model: Sequential Assignment
Masking: None (Open Label)

Contacts and Locations

Central Contacts: Paul L Hess, MD MSContact
paul.hess@va.gov(720) 857-6889

Similar Studies

Participant Group/Arms

Pharmacist/Cardiologist Virtual Team (Intervention)Experimental

VA medical centers randomized to the active intervention period receive digital consultation from a centralized pharmacist and cardiologist virtual team regarding guideline-directed medical therapy for hospitalized Veterans with heart failure and during the post-discharge period. The intervention includes identification of eligible Veterans, placement of digital consultation notes in the EHR, facilitation of outpatient follow-up, and Veteran education.

Behavioral: Pharmacist/Cardiologist Virtual Team Digital Consultation

Usual Care (Control Period)No Intervention

VA medical centers during their pre-implementation (control) period provide usual care for Veterans hospitalized with heart failure without input from the pharmacist/cardiologist virtual team. In the stepped-wedge design, all sites eventually cross over to the intervention arm.