Trial results for a pragmatic study investigating provider messaging for Heart Failure With Reduced Ejection Fraction (HFrEF) treatment were posted on ClinicalTrials.gov on 2025-07-01. The trial, which enrolled 1410 participants, indicated that an electronic health record (EHR)-based alert led to an increase in prescribed HFrEF therapy compared to usual care.

Background

Heart Failure With Reduced Ejection Fraction (HFrEF) is a chronic and progressive condition where the heart muscle does not pump blood as well as it should. Optimal management of HFrEF relies on the timely and appropriate prescription of evidence-based medications, including beta blockers, ACE inhibitors, ARBs, ARNIs, and MRAs, which have been shown to improve patient outcomes. However, adherence to these guidelines can be challenging for healthcare providers in busy clinical settings. Interventions that support providers in initiating or intensifying guideline-directed medical therapy are crucial for improving patient care and reducing morbidity and mortality associated with HFrEF.

Trial design

This completed randomized controlled trial, designated as Phase NA, enrolled a total of 1410 participants. The study focused on patients with Heart Failure With Reduced Ejection Fraction across outpatient clinics within a single health system. The trial compared the efficacy of an electronic health record-based alert, which informed providers about evidence-based medications for HFrEF, against usual care, where no such alert was provided. The intervention aimed to facilitate the uptake of guideline-recommended therapies.

Key results

The trial reported several key measurements comparing the EHR-based alert group to the usual care group:

What this means

The results suggest that an EHR-based alert system can effectively increase the number of patients receiving intensified or initiated evidence-based therapy for Heart Failure With Reduced Ejection Fraction. Specifically, the alert appears to have positively influenced the prescription rates of several key HFrEF medications, including beta blockers, ARBs, ARNIs, and MRAs. While the number of patients on ACE inhibitors was slightly lower in the alert group, the overall trend indicates that such digital interventions can serve as a valuable tool for healthcare systems aiming to improve adherence to clinical guidelines and potentially enhance outcomes for patients with HFrEF.

Source

The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT04514458, titled "Pragmatic Trial of Messaging to Providers About Treatment of Heart Failure", were posted on 2025-07-01 on clinicaltrials.gov.