Status
Completed
Phase
Not applicable
Enrollment
115
Locations
1
Results
Not posted
Publications
0
Study summary
This proposal examines use of a clinical reminder to the primary provider of patient with a high B type natriuretic peptide but no prior imaging. Electrical Medical Record-based Intervention to Determine whether Clinical Reminders Improve Heart Failure Management in Patients with High BNP Values and Unknown LVEF.
Rationale: B type natriuretic peptide is known to be elevated (\> 100 pg/ml) in patients with heart failure. Furthermore, treatments are available to improve survival and reduce hospitalization if the left ventricular ejection fraction (LVEF) is \< 40%. Accordingly, guidelines recommend an LVEF measure for patients with suspected heart failure. Prior work has demonstrated that patients with high BNP values do not always have a measure of left ventricular ejection. Hypothesis: A reminder to patients with BNP and no imaging may prompt providers to order appropriate imaging potentially leading to 1) identification of unsuspected depressed ejection fraction and 2) more appropriate treatment.
Interventions
OTHER
A note is sent to the primary care provider using the electronic medical record indicating the high BNP result and potential benefit of measurement of the left ventricular ejection fraction. A draft order is placed for an echocardiogram for the provider to accept or delete.
Timeline
First posted
Nov 27, 2012
Study start
Oct 2010
Primary completion
Sep 2013
Study completion
Sep 2015
Results posted
Not reported
Registry updated
Sep 19, 2025
Outcomes
Measurement of left ventricular ejection fraction
Time frame · 6 months after randomization
numerator: Measurement of left ventricular ejection fraction within 6 months of randomization. denominator: All randomized patients
Identification of LVEF < 40%
Time frame · 6 months following randomizaiton
Numerator: number of patients identified with an LVEF\< 40% Denominator: all randomized patients
Treatment of Low LVEF
Time frame · 6 months following randomization
Numerator: number of patients with an LVEF \< 40% and treatment with either an angiotensin converting enzyme inhibitor, angiotensin receptor blocker or evidence based beta-blocker (carvedilol, metoprolol succinate, bisoprolol). Denominator: all randomized patients.
Eligibility
Inclusion Criteria: * BNP \>= 200 pg/ml in last 2 months Exclusion Criteria: * Measure of LVEF in the last 12 months * Last measure of LVEF \< 40%
Study locations
United States. Showing up to 24 locations stored in the fast local snapshot.
VA Palo Alto Health Care System
Palo Alto, California, United States
Publications
No PMID-linked publications were present in this registry snapshot.
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