Trial results for an "Informational Nudge to Improve Heart Failure Prescribing" study were posted on ClinicalTrials.gov on 2026-05-01. The study, involving 81 participants, investigated strategies to improve prescribing of guideline-recommended therapies for Heart Failure, finding that various clinician nudges led to 2 MRA prescriptions each compared to 0 in the control group.
Background
Heart Failure is a chronic condition where the heart cannot pump enough blood to meet the body's needs. Guideline-recommended therapies, such as SGLT2 inhibitors and Mineralocorticoid Receptor Antagonists (MRAs), are known to save lives and prevent hospitalizations for patients with heart failure. However, a significant gap in care exists, with only a third or fewer eligible Veterans currently receiving these beneficial treatments. This study aimed to address this critical gap by exploring strategies to improve the uptake of these essential medications.
Trial design
This completed study, designated as Phase NA, enrolled 81 participants to compare the effect of clinician-directed nudges as strategies to improve the health of Veterans with Heart Failure. The study focused on the condition of Heart Failure. The intervention involved comparing a control group against three intervention groups: one receiving an Alert, another receiving a Peer Comparison Report, and a third receiving Both Alert and Peer Comparison Report, all designed to improve prescribing practices.
Key results
The study collected several key measurements related to the effectiveness of the informational nudges, clinician reach, and incidence of deprescribing:
- Effectiveness (MRA Prescriptions):
- The Control group recorded 0 Count of MRA prescriptions Filled.
- The Alert group recorded 2 Count of MRA prescriptions Filled.
- The Peer Comparison Report group recorded 2 Count of MRA prescriptions Filled.
- The Both Alert and Peer Comparison Report group recorded 2 Count of MRA prescriptions Filled.
- Reach-Clinician:
- The Control group had 0 Participants.
- The Alert group reached 19 Participants.
- The Peer Comparison Report group reached 21 Participants.
- The Both Alert and Peer Comparison Report group reached 22 Participants.
- Incidence of Treatment Emergent Adverse Events (SGLT2 Deprescribed):
- In the Alert (Group 2), 3 Deprescribed patients were noted for SGLT2.
- In the Peer Comparison Report (Group 3), 0 Deprescribed patients were noted for SGLT2.
- In the Alert & Peer Comparison Report (Group 4), 2 Deprescribed patients were noted for SGLT2.
- Incidence of Treatment Emergent Adverse Events (MRA Deprescribed):
- In the Alert (Group 2), 1 Deprescribed patient was noted for MRA.
What this means
The results suggest that informational nudges directed at clinicians can positively influence the prescribing of guideline-recommended MRA therapies for Heart Failure. All three intervention groups—Alert, Peer Comparison Report, and Both Alert and Peer Comparison Report—resulted in 2 MRA prescriptions each, a notable increase compared to the 0 prescriptions observed in the Control group. This indicates that even simple informational interventions can help bridge the existing gap in care for eligible patients. The clinician reach data further supports the feasibility of implementing such strategies. While some instances of SGLT2 and MRA deprescribing were noted across the intervention groups, the overall trend points towards the utility of these nudges in improving adherence to treatment guidelines for Heart Failure.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for study NCT05986695, titled "Informational Nudge to Improve Heart Failure Prescribing", were posted on 2026-05-01 on clinicaltrials.gov.