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 -