TY - JOUR

T1 - Telemedicine Support for Primary Care Providers versus Usual Care in Patients with Heart Failure

T2 - Protocol of a Pragmatic Cluster Randomised Trial within the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) Study

AU - Graever, Leonardo

AU - Issa, Aurora Felice Castro

AU - Fonseca, Viviane Belidio Pinheiro da

AU - Melo, Marcelo Machado

AU - Silva, Gabriel Pesce de Castro da

AU - Nóbrega, Isabel Cristina Pacheco da

AU - Savassi, Leonardo Cançado Monteiro

AU - Dias, Mariana Borges

AU - Gomes, Maria Kátia

AU - Lapa e Silva, Jose Roberto

AU - Guimarães, Raphael Mendonça

AU - Seródio, Renato Cony

AU - Frølich, Anne

AU - Gudbergsen, Henrik

AU - Jakobsen, Janus Christian

AU - Dominguez, Helena

N1 - Publisher Copyright: © 2023 by the authors.

PY - 2023

Y1 - 2023

N2 - Heart failure is a prevalent condition and a frequent cause of hospital readmissions and poor quality of life. Teleconsultation support from cardiologists to primary care physicians managing patients with heart failure may improve care, but the effect on patient-relevant outcomes is unclear. We aim to evaluate whether collaboration through a novel teleconsultation platform in the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) project, tested on a previous feasibility study, can improve patient-relevant outcomes. We will conduct a parallel-group, two-arm, cluster-randomised superiority trial with a 1:1 allocation ratio, with primary care practices from Rio de Janeiro as clusters. Physicians from the intervention group practices will receive teleconsultation support from a cardiologist to assist patients discharged from hospitals after admission for heart failure. In contrast, physicians from the control group practices will perform usual care. We will include 10 patients per each of the 80 enrolled practices (n = 800). The primary outcome will be a composite of mortality and hospital admissions after six months. Secondary outcomes will be adverse events, symptoms frequency, quality of life, and primary care physicians’ compliance with treatment guidelines. We hypothesise that teleconsulting support will improve patient outcomes.

AB - Heart failure is a prevalent condition and a frequent cause of hospital readmissions and poor quality of life. Teleconsultation support from cardiologists to primary care physicians managing patients with heart failure may improve care, but the effect on patient-relevant outcomes is unclear. We aim to evaluate whether collaboration through a novel teleconsultation platform in the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) project, tested on a previous feasibility study, can improve patient-relevant outcomes. We will conduct a parallel-group, two-arm, cluster-randomised superiority trial with a 1:1 allocation ratio, with primary care practices from Rio de Janeiro as clusters. Physicians from the intervention group practices will receive teleconsultation support from a cardiologist to assist patients discharged from hospitals after admission for heart failure. In contrast, physicians from the control group practices will perform usual care. We will include 10 patients per each of the 80 enrolled practices (n = 800). The primary outcome will be a composite of mortality and hospital admissions after six months. Secondary outcomes will be adverse events, symptoms frequency, quality of life, and primary care physicians’ compliance with treatment guidelines. We hypothesise that teleconsulting support will improve patient outcomes.

KW - clinical competence

KW - cluster randomized trial

KW - heart failure

KW - primary health care

KW - telemedicine

UR - http://www.scopus.com/inward/record.url?scp=85163088304&partnerID=8YFLogxK

U2 - 10.3390/ijerph20115933

DO - 10.3390/ijerph20115933

M3 - Journal article

C2 - 37297537

AN - SCOPUS:85163088304

VL - 20

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

SN - 1661-7827

IS - 11

M1 - 5933

ER -