Telemedicine Support for Primary Care Providers versus Usual Care in Patients with Heart Failure: Protocol of a Pragmatic Cluster Randomised Trial within the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) Study
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...
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| Veröffentlicht in: | International journal of environmental research and public health 2023-05, Vol.20 (11), p.5933 |
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| creator | Graever, Leonardo Issa, Aurora Felice Castro Fonseca, Viviane Belidio Pinheiro da Melo, Marcelo Machado Silva, Gabriel Pesce de Castro da Nóbrega, Isabel Cristina Pacheco da Savassi, Leonardo Cançado Monteiro Dias, Mariana Borges Gomes, Maria Kátia Lapa E Silva, Jose Roberto Guimarães, Raphael Mendonça Seródio, Renato Cony Frølich, Anne Gudbergsen, Henrik Jakobsen, Janus Christian Dominguez, Helena |
| description | 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. |
| doi_str_mv | 10.3390/ijerph20115933 |
| format | Article |
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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.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph20115933</identifier><identifier>PMID: 37297537</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Brazil ; Cardiac patients ; Cardiology ; Care and treatment ; Case management ; Collaboration ; Congestive heart failure ; Emergency medical care ; Family medicine ; Feasibility studies ; Health care ; Heart failure ; Heart Failure - therapy ; Hospitals ; Humans ; Intervention ; Medical care ; Medical research ; Medicine ; Medicine, Experimental ; Mortality ; Patient admissions ; Patients ; Physicians ; Practice ; Primary care ; Primary Health Care ; Protocol ; Quality management ; Quality of Life ; Randomized Controlled Trials as Topic ; Teams ; Telemedicine ; Telemedicine - methods</subject><ispartof>International journal of environmental research and public health, 2023-05, Vol.20 (11), p.5933</ispartof><rights>COPYRIGHT 2023 MDPI AG</rights><rights>2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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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. 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| ispartof | International journal of environmental research and public health, 2023-05, Vol.20 (11), p.5933 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; MDPI - Multidisciplinary Digital Publishing Institute; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Brazil Cardiac patients Cardiology Care and treatment Case management Collaboration Congestive heart failure Emergency medical care Family medicine Feasibility studies Health care Heart failure Heart Failure - therapy Hospitals Humans Intervention Medical care Medical research Medicine Medicine, Experimental Mortality Patient admissions Patients Physicians Practice Primary care Primary Health Care Protocol Quality management Quality of Life Randomized Controlled Trials as Topic Teams Telemedicine Telemedicine - methods |
| title | Telemedicine Support for Primary Care Providers versus Usual Care in Patients with Heart Failure: Protocol of a Pragmatic Cluster Randomised Trial within the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) Study |
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