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Therapy optimalisation of heart failure in primary care Utrecht.


- candidate number8680
- NTR NumberNTR2596
- ISRCTNISRCTN wordt niet meer aangevraagd.
- Date ISRCTN created
- date ISRCTN requested
- Date Registered NTR18-nov-2010
- Secondary IDsNL29397.100.10 CCMO
- Public TitleTherapy optimalisation of heart failure in primary care Utrecht.
- Scientific TitleTherapy optimalisation of heart failure in primary care Utrecht.
- ACRONYMTOPHU
- hypothesisBy training GP's in medical treatment of patients with heart failure, more patients with heart failure with lowered ejection fraction (HFLEF) use beta blockers in a more optimal dose with a beter quality of live.
- Healt Condition(s) or Problem(s) studiedBeta-blocker, Quality of life, Heart failure, Therapy
- Inclusion criteriaPatients with chronic heart failure with preserved or lowered ejection fraction treated by a general practitioner.
- Exclusion criteriaPatients with other causes of dyspneua.
- mec approval receivedyes
- multicenter trialyes
- randomisedyes
- masking/blindingNone
- controlActive
- groupParallel
- Type2 or more arms, randomized
- Studytypeintervention
- planned startdate 1-jun-2010
- planned closingdate31-dec-2013
- Target number of participants730
- InterventionsFrom all the patients with the ICPC-code K77 (heart failure) only the named heartfailure wil get medically optimised. The GP diagnosis of heart failure is mostly based on signs and symptoms. Because of that, there is uncertainty of diagnosis. To be sure what kind of heart failure the GP is treating, he needs an echocardiografy. It is essential to know the ejection fraction (EF). The patients with a lowered EF wil get diuretics, ACE-inhibitors and Beta-blockers. The patients with preserved diastolic function need to be treated correct for the hypertension and pulse. It is known there is an undertreatment by GP's, principally for beta-blockers. A short training of the GP's of the intervention group wil teach them to optimise the prescription of beta-blockers. It could be improved from 30 til 60%.
- Primary outcomeThe difference in percentage of patients with heart failure with ejection fraction (EF) <45% using beta blockers between the intervention and control group.
- Secondary outcomeMeasure the prevalence of COPD at patients known with heart failure.
- Timepoints1. Oct 2010 training;
2. Oct 2010-mar 2011 intervention;
3. Apr 2011-dec 2011 data analyses.
- Trial web siteN/A
- statusopen: patient inclusion
- CONTACT FOR PUBLIC QUERIES Mark J.M. Valk
- CONTACT for SCIENTIFIC QUERIES Mark J.M. Valk
- Sponsor/Initiator University Medical Center Utrecht (UMCU)
- Funding
(Source(s) of Monetary or Material Support)
Agis Health Insurance
- PublicationsN/A
- Brief summaryGP's diagnosis of heart failure (HF) is mostly based on signs and symptoms. Because of that there is an uncertainty of the diagnosis, because without an echocardiografy, the full diagnosis can not be made. To treat the patient optimal, you need an ejection fraction (EF). EF<45% is systolic HF and is treated with diuretics, ACE-inhibitors and beta-blockers. Patients with EF>45% need to be treated for there hypertensin and pulse rate according the duth guide lines. There is room for improvement.Beta-bloker use is now 30% and we try to improve this to 60% bij a short training of the GP's. QoL wil increas, hospitalisation and mortality wil reduce. Unknown is wat part of the patient with HF have COPD. We are going to explore this. The control group wil give care as usual. After half a year we wil compare the prescriptions made bij the GP's in the intervention group , with the prescription at start and with the controle group. Patients get a questionnaire at start and 4 weeks after optimisition their medical treatment for HF.
- Main changes (audit trail)
- RECORD18-nov-2010 - 20-nov-2010


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