Ignite Creation Date:
2025-12-25 @ 4:27 AM
Ignite Modification Date:
2026-03-03 @ 3:30 AM
Study NCT ID:
NCT05275920
Status:
COMPLETED
Last Update Posted:
2024-10-09
First Post:
2022-02-09
Is NOT Gene Therapy:
True
Has Adverse Events:
True
Brief Title:
Building Electronic Tools To Enhance and Reinforce CArdiovascular REcommendations - Heart Failure (BETTER CARE-HF)
Sponsor:
Organization:
Raw JSON
{'hasResults': True, 'derivedSection': {'miscInfoModule': {'versionHolder': '2025-12-24'}, 'conditionBrowseModule': {'meshes': [{'id': 'D006333', 'term': 'Heart Failure'}], 'ancestors': [{'id': 'D006331', 'term': 'Heart Diseases'}, {'id': 'D002318', 'term': 'Cardiovascular Diseases'}]}}, 'resultsSection': {'moreInfoModule': {'pointOfContact': {'email': 'amrita.mukhopadhyay@nyulangone.org', 'phone': '212-263-7751', 'title': 'Amrita Mukhopadhyay, MD', 'organization': 'NYU Langone Health'}, 'certainAgreement': {'piSponsorEmployee': True}}, 'adverseEventsModule': {'timeFrame': 'Up to 90 days after intervention completion, an average of 6 months', 'description': 'Assessed using electronic health record (EHR) data.', 'eventGroups': [{'id': 'EG000', 'title': 'Best Practice Alert Group - Prescribed MRA', 'description': 'Participants in the Best Practice Alert group who were prescribed MRA.', 'otherNumAtRisk': 224, 'deathsNumAtRisk': 224, 'otherNumAffected': 35, 'seriousNumAtRisk': 224, 'deathsNumAffected': 2, 'seriousNumAffected': 0}, {'id': 'EG001', 'title': 'In-Basket Message Group - Prescribed MRA', 'description': 'Participants in the In-Basket Message group who were prescribed MRA.', 'otherNumAtRisk': 127, 'deathsNumAtRisk': 127, 'otherNumAffected': 12, 'seriousNumAtRisk': 127, 'deathsNumAffected': 0, 'seriousNumAffected': 0}, {'id': 'EG002', 'title': 'Control Group - Prescribed MRA', 'description': 'Participants in the control group who were prescribed MRA.', 'otherNumAtRisk': 75, 'deathsNumAtRisk': 75, 'otherNumAffected': 8, 'seriousNumAtRisk': 75, 'deathsNumAffected': 0, 'seriousNumAffected': 0}, {'id': 'EG003', 'title': 'Best Practice Alert Group - Not Prescribed MRA', 'description': 'Participants in the Best Practice Alert group who were not prescribed MRA.', 'otherNumAtRisk': 531, 'deathsNumAtRisk': 531, 'otherNumAffected': 37, 'seriousNumAtRisk': 531, 'deathsNumAffected': 0, 'seriousNumAffected': 0}, {'id': 'EG004', 'title': 'In-Basket Message Group - Not Prescribed MRA', 'description': 'Participants in the In-Basket Message group who were not prescribed MRA.', 'otherNumAtRisk': 685, 'deathsNumAtRisk': 685, 'otherNumAffected': 44, 'seriousNumAtRisk': 685, 'deathsNumAffected': 5, 'seriousNumAffected': 0}, {'id': 'EG005', 'title': 'Control Group - Not Prescribed MRA', 'description': 'Participants in the control group who were not prescribed MRA.', 'otherNumAtRisk': 569, 'deathsNumAtRisk': 569, 'otherNumAffected': 31, 'seriousNumAtRisk': 569, 'deathsNumAffected': 5, 'seriousNumAffected': 0}], 'otherEvents': [{'term': 'Hyperkalemia', 'stats': [{'groupId': 'EG000', 'numAtRisk': 224, 'numAffected': 30}, {'groupId': 'EG001', 'numAtRisk': 127, 'numAffected': 12}, {'groupId': 'EG002', 'numAtRisk': 75, 'numAffected': 8}, {'groupId': 'EG003', 'numAtRisk': 531, 'numAffected': 37}, {'groupId': 'EG004', 'numAtRisk': 685, 'numAffected': 43}, {'groupId': 'EG005', 'numAtRisk': 569, 'numAffected': 31}], 'organSystem': 'Renal and urinary disorders', 'assessmentType': 'SYSTEMATIC_ASSESSMENT'}, {'term': 'Significant Hyperkalemia', 'stats': [{'groupId': 'EG000', 'numAtRisk': 224, 'numAffected': 12}, {'groupId': 'EG001', 'numAtRisk': 127, 'numAffected': 8}, {'groupId': 'EG002', 'numAtRisk': 75, 'numAffected': 3}, {'groupId': 'EG003', 'numAtRisk': 531, 'numAffected': 14}, {'groupId': 'EG004', 'numAtRisk': 685, 'numAffected': 15}, {'groupId': 'EG005', 'numAtRisk': 569, 'numAffected': 12}], 'organSystem': 'Renal and urinary disorders', 'assessmentType': 'SYSTEMATIC_ASSESSMENT'}, {'term': 'Newly documented adverse reaction/intolerance to MRA', 'stats': [{'groupId': 'EG000', 'numAtRisk': 224, 'numAffected': 6}, {'groupId': 'EG001', 'numAtRisk': 127, 'numAffected': 0}, {'groupId': 'EG002', 'numAtRisk': 75, 'numAffected': 0}, {'groupId': 'EG003', 'numAtRisk': 531, 'numAffected': 0}, {'groupId': 'EG004', 'numAtRisk': 685, 'numAffected': 1}, {'groupId': 'EG005', 'numAtRisk': 569, 'numAffected': 0}], 'organSystem': 'General disorders', 'assessmentType': 'SYSTEMATIC_ASSESSMENT'}], 'frequencyThreshold': '0'}, 'outcomeMeasuresModule': {'outcomeMeasures': [{'type': 'PRIMARY', 'title': 'Number of Participants Prescribed Mineralocorticoid Receptor Antagonists (MRA) During Study', 'denoms': [{'units': 'Participants', 'counts': [{'value': '755', 'groupId': 'OG000'}, {'value': '812', 'groupId': 'OG001'}, {'value': '644', 'groupId': 'OG002'}]}], 'groups': [{'id': 'OG000', 'title': 'Best Practice Alert Group', 'description': "Providers will receive a BPA at the time of visit for patients with HFrEF who are not on MRA (and who do not have contraindication to MRA). This alert will display the patient's current HFrEF therapies, EF, blood pressure, potassium, and glomerular filtration rate. The alert will give access to an outpatient heart failure order set, and also provide links to the most recent guidelines.\n\nBest Practice Alert (BPA): A BPA will fire in the EHR reminding care providers of the best practice when prescribing medical therapies for heart failure patients."}, {'id': 'OG001', 'title': 'In-Basket Message Group', 'description': "Providers will receive a monthly in-basket messages linking to a list of patients who have been seen in the past 2 months or will be seen in the upcoming month with HFrEF who are not on MRA (and who do not have contraindication to MRA). This list will display each patient's current hFrEF therapies, EF, blood pressure, potassium, glomerular filtration rate, date of last visit, and date of next visit. From the list, providers can access the patient's chart, order medications, and document communication with the patient.\n\nIn-Basket Message: An In-Basket message will be sent biweekly to care providers with a reminder of the best practice when prescribing medical therapies for heart failure"}, {'id': 'OG002', 'title': 'Control Group', 'description': 'Patients who will receive the current standard practice of care (no BPA or in-basket message)'}], 'classes': [{'categories': [{'measurements': [{'value': '224', 'groupId': 'OG000'}, {'value': '127', 'groupId': 'OG001'}, {'value': '75', 'groupId': 'OG002'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'timeFrame': 'Through study completion, an average of 6 months', 'unitOfMeasure': 'Participants', 'reportingStatus': 'POSTED'}, {'type': 'SECONDARY', 'title': 'Number of Participants Prescribed to Beta-blocker (BB), Angiotensin Converting Enzyme (ACE) Inhibitor, Angiotensin Receptor Blocker (ARB), or Angiotensin Receptor/Neprilysin Inhibitor (ARNI) During Study', 'denoms': [{'units': 'Participants', 'counts': [{'value': '755', 'groupId': 'OG000'}, {'value': '812', 'groupId': 'OG001'}, {'value': '644', 'groupId': 'OG002'}]}], 'groups': [{'id': 'OG000', 'title': 'Best Practice Alert Group', 'description': "Providers will receive a BPA at the time of visit for patients with HFrEF who are not on MRA (and who do not have contraindication to MRA). This alert will display the patient's current HFrEF therapies, EF, blood pressure, potassium, and glomerular filtration rate. The alert will give access to an outpatient heart failure order set, and also provide links to the most recent guidelines.\n\nBest Practice Alert (BPA): A BPA will fire in the EHR reminding care providers of the best practice when prescribing medical therapies for heart failure patients."}, {'id': 'OG001', 'title': 'In-Basket Message Group', 'description': "Providers will receive a monthly in-basket messages linking to a list of patients who have been seen in the past 2 months or will be seen in the upcoming month with HFrEF who are not on MRA (and who do not have contraindication to MRA). This list will display each patient's current hFrEF therapies, EF, blood pressure, potassium, glomerular filtration rate, date of last visit, and date of next visit. From the list, providers can access the patient's chart, order medications, and document communication with the patient.\n\nIn-Basket Message: An In-Basket message will be sent biweekly to care providers with a reminder of the best practice when prescribing medical therapies for heart failure"}, {'id': 'OG002', 'title': 'Control Group', 'description': 'Patients who will receive the current standard practice of care (no BPA or in-basket message)'}], 'classes': [{'categories': [{'measurements': [{'value': '87', 'groupId': 'OG000'}, {'value': '94', 'groupId': 'OG001'}, {'value': '85', 'groupId': 'OG002'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'timeFrame': 'Through study completion, an average of 6 months', 'unitOfMeasure': 'Participants', 'reportingStatus': 'POSTED'}]}, 'participantFlowModule': {'groups': [{'id': 'FG000', 'title': 'Best Practice Alert Group', 'description': "Providers will receive a BPA at the time of visit for patients with HFrEF who are not on MRA (and who do not have contraindication to MRA). This alert will display the patient's current HFrEF therapies, EF, blood pressure, potassium, and glomerular filtration rate. The alert will give access to an outpatient heart failure order set, and also provide links to the most recent guidelines.\n\nBest Practice Alert (BPA): A BPA will fire in the EHR reminding care providers of the best practice when prescribing medical therapies for heart failure patients."}, {'id': 'FG001', 'title': 'In-Basket Message Group', 'description': "Providers will receive a monthly in-basket messages linking to a list of patients who have been seen in the past 2 months or will be seen in the upcoming month with HFrEF who are not on MRA (and who do not have contraindication to MRA). This list will display each patient's current hFrEF therapies, EF, blood pressure, potassium, glomerular filtration rate, date of last visit, and date of next visit. From the list, providers can access the patient's chart, order medications, and document communication with the patient.\n\nIn-Basket Message: An In-Basket message will be sent biweekly to care providers with a reminder of the best practice when prescribing medical therapies for heart failure"}, {'id': 'FG002', 'title': 'Control Group', 'description': 'Patients who will receive the current standard practice of care (no BPA or in-basket message)'}], 'periods': [{'title': 'Overall Study', 'milestones': [{'type': 'STARTED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '755'}, {'groupId': 'FG001', 'numSubjects': '812'}, {'groupId': 'FG002', 'numSubjects': '644'}]}, {'type': 'COMPLETED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '755'}, {'groupId': 'FG001', 'numSubjects': '812'}, {'groupId': 'FG002', 'numSubjects': '644'}]}, {'type': 'NOT COMPLETED', 'achievements': [{'groupId': 'FG000', 'numSubjects': '0'}, {'groupId': 'FG001', 'numSubjects': '0'}, {'groupId': 'FG002', 'numSubjects': '0'}]}]}]}, 'baselineCharacteristicsModule': {'denoms': [{'units': 'Participants', 'counts': [{'value': '755', 'groupId': 'BG000'}, {'value': '812', 'groupId': 'BG001'}, {'value': '644', 'groupId': 'BG002'}, {'value': '2211', 'groupId': 'BG003'}]}], 'groups': [{'id': 'BG000', 'title': 'Best Practice Alert Group', 'description': "Providers will receive a BPA at the time of visit for patients with HFrEF who are not on MRA (and who do not have contraindication to MRA). This alert will display the patient's current HFrEF therapies, EF, blood pressure, potassium, and glomerular filtration rate. The alert will give access to an outpatient heart failure order set, and also provide links to the most recent guidelines.\n\nBest Practice Alert (BPA): A BPA will fire in the EHR reminding care providers of the best practice when prescribing medical therapies for heart failure patients."}, {'id': 'BG001', 'title': 'In-Basket Message Group', 'description': "Providers will receive a monthly in-basket messages linking to a list of patients who have been seen in the past 2 months or will be seen in the upcoming month with HFrEF who are not on MRA (and who do not have contraindication to MRA). This list will display each patient's current hFrEF therapies, EF, blood pressure, potassium, glomerular filtration rate, date of last visit, and date of next visit. From the list, providers can access the patient's chart, order medications, and document communication with the patient.\n\nIn-Basket Message: An In-Basket message will be sent biweekly to care providers with a reminder of the best practice when prescribing medical therapies for heart failure"}, {'id': 'BG002', 'title': 'Control Group', 'description': 'Patients who will receive the current standard practice of care (no BPA or in-basket message)'}, {'id': 'BG003', 'title': 'Total', 'description': 'Total of all reporting groups'}], 'measures': [{'title': 'Age, Continuous', 'classes': [{'categories': [{'measurements': [{'value': '73.0', 'groupId': 'BG000', 'lowerLimit': '64.0', 'upperLimit': '81.0'}, {'value': '73.0', 'groupId': 'BG001', 'lowerLimit': '65.0', 'upperLimit': '83.0'}, {'value': '74.0', 'groupId': 'BG002', 'lowerLimit': '63.0', 'upperLimit': '81.0'}, {'value': '73.0', 'groupId': 'BG003', 'lowerLimit': '64.0', 'upperLimit': '82.0'}]}]}], 'paramType': 'MEDIAN', 'unitOfMeasure': 'years', 'dispersionType': 'INTER_QUARTILE_RANGE'}, {'title': 'Sex: Female, Male', 'classes': [{'categories': [{'title': 'Female', 'measurements': [{'value': '220', 'groupId': 'BG000'}, {'value': '209', 'groupId': 'BG001'}, {'value': '204', 'groupId': 'BG002'}, {'value': '633', 'groupId': 'BG003'}]}, {'title': 'Male', 'measurements': [{'value': '535', 'groupId': 'BG000'}, {'value': '603', 'groupId': 'BG001'}, {'value': '440', 'groupId': 'BG002'}, {'value': '1578', 'groupId': 'BG003'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'unitOfMeasure': 'Participants'}, {'title': 'Ethnicity (NIH/OMB)', 'classes': [{'categories': [{'title': 'Hispanic or Latino', 'measurements': [{'value': '103', 'groupId': 'BG000'}, {'value': '82', 'groupId': 'BG001'}, {'value': '66', 'groupId': 'BG002'}, {'value': '251', 'groupId': 'BG003'}]}, {'title': 'Not Hispanic or Latino', 'measurements': [{'value': '600', 'groupId': 'BG000'}, {'value': '668', 'groupId': 'BG001'}, {'value': '532', 'groupId': 'BG002'}, {'value': '1800', 'groupId': 'BG003'}]}, {'title': 'Unknown or Not Reported', 'measurements': [{'value': '52', 'groupId': 'BG000'}, {'value': '62', 'groupId': 'BG001'}, {'value': '46', 'groupId': 'BG002'}, {'value': '160', 'groupId': 'BG003'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'unitOfMeasure': 'Participants'}, {'title': 'Race (NIH/OMB)', 'classes': [{'categories': [{'title': 'American Indian or Alaska Native', 'measurements': [{'value': '1', 'groupId': 'BG000'}, {'value': '0', 'groupId': 'BG001'}, {'value': '3', 'groupId': 'BG002'}, {'value': '4', 'groupId': 'BG003'}]}, {'title': 'Asian', 'measurements': [{'value': '28', 'groupId': 'BG000'}, {'value': '28', 'groupId': 'BG001'}, {'value': '27', 'groupId': 'BG002'}, {'value': '83', 'groupId': 'BG003'}]}, {'title': 'Native Hawaiian or Other Pacific Islander', 'measurements': [{'value': '2', 'groupId': 'BG000'}, {'value': '0', 'groupId': 'BG001'}, {'value': '2', 'groupId': 'BG002'}, {'value': '4', 'groupId': 'BG003'}]}, {'title': 'Black or African American', 'measurements': [{'value': '78', 'groupId': 'BG000'}, {'value': '57', 'groupId': 'BG001'}, {'value': '56', 'groupId': 'BG002'}, {'value': '191', 'groupId': 'BG003'}]}, {'title': 'White', 'measurements': [{'value': '490', 'groupId': 'BG000'}, {'value': '586', 'groupId': 'BG001'}, {'value': '448', 'groupId': 'BG002'}, {'value': '1524', 'groupId': 'BG003'}]}, {'title': 'More than one race', 'measurements': [{'value': '75', 'groupId': 'BG000'}, {'value': '75', 'groupId': 'BG001'}, {'value': '46', 'groupId': 'BG002'}, {'value': '196', 'groupId': 'BG003'}]}, {'title': 'Unknown or Not Reported', 'measurements': [{'value': '81', 'groupId': 'BG000'}, {'value': '66', 'groupId': 'BG001'}, {'value': '62', 'groupId': 'BG002'}, {'value': '209', 'groupId': 'BG003'}]}]}], 'paramType': 'COUNT_OF_PARTICIPANTS', 'unitOfMeasure': 'Participants'}, {'title': 'Region of Enrollment', 'classes': [{'title': 'United States', 'categories': [{'measurements': [{'value': '755', 'groupId': 'BG000'}, {'value': '812', 'groupId': 'BG001'}, {'value': '644', 'groupId': 'BG002'}, {'value': '2211', 'groupId': 'BG003'}]}]}], 'paramType': 'NUMBER', 'unitOfMeasure': 'participants'}]}}, 'documentSection': {'largeDocumentModule': {'largeDocs': [{'date': '2023-02-14', 'size': 495440, 'label': 'Study Protocol and Statistical Analysis Plan', 'hasIcf': False, 'hasSap': True, 'filename': 'Prot_SAP_000.pdf', 'typeAbbrev': 'Prot_SAP', 'uploadDate': '2023-10-25T15:40', 'hasProtocol': True}]}}, 'protocolSection': {'designModule': {'phases': ['NA'], 'studyType': 'INTERVENTIONAL', 'designInfo': {'allocation': 'RANDOMIZED', 'maskingInfo': {'masking': 'TRIPLE', 'whoMasked': ['PARTICIPANT', 'INVESTIGATOR', 'OUTCOMES_ASSESSOR']}, 'primaryPurpose': 'SUPPORTIVE_CARE', 'interventionModel': 'PARALLEL'}, 'enrollmentInfo': {'type': 'ACTUAL', 'count': 2211}}, 'statusModule': {'overallStatus': 'COMPLETED', 'startDateStruct': {'date': '2022-04-28', 'type': 'ACTUAL'}, 'expandedAccessInfo': {'hasExpandedAccess': False}, 'statusVerifiedDate': '2024-10', 'completionDateStruct': {'date': '2022-10-26', 'type': 'ACTUAL'}, 'lastUpdateSubmitDate': '2024-10-02', 'studyFirstSubmitDate': '2022-02-09', 'resultsFirstSubmitDate': '2023-10-25', 'studyFirstSubmitQcDate': '2022-03-02', 'lastUpdatePostDateStruct': {'date': '2024-10-09', 'type': 'ACTUAL'}, 'resultsFirstSubmitQcDate': '2024-10-02', 'studyFirstPostDateStruct': {'date': '2022-03-11', 'type': 'ACTUAL'}, 'resultsFirstPostDateStruct': {'date': '2024-10-09', 'type': 'ACTUAL'}, 'primaryCompletionDateStruct': {'date': '2022-10-26', 'type': 'ACTUAL'}}, 'outcomesModule': {'primaryOutcomes': [{'measure': 'Number of Participants Prescribed Mineralocorticoid Receptor Antagonists (MRA) During Study', 'timeFrame': 'Through study completion, an average of 6 months'}], 'secondaryOutcomes': [{'measure': 'Number of Participants Prescribed to Beta-blocker (BB), Angiotensin Converting Enzyme (ACE) Inhibitor, Angiotensin Receptor Blocker (ARB), or Angiotensin Receptor/Neprilysin Inhibitor (ARNI) During Study', 'timeFrame': 'Through study completion, an average of 6 months'}]}, 'oversightModule': {'oversightHasDmc': False, 'isFdaRegulatedDrug': False, 'isFdaRegulatedDevice': False}, 'conditionsModule': {'keywords': ['Best Practice Alert [BPA]', 'In-Basket message', 'Mineralocorticoid Receptor Antagonists [MRA]', 'guideline-directed medical therapy [GDMT]', 'Clinical decision support'], 'conditions': ['Heart Failure', 'Heart Failure With Reduced Ejection Fraction']}, 'referencesModule': {'references': [{'pmid': '38043045', 'type': 'DERIVED', 'citation': 'Mukhopadhyay A, Reynolds HR, King WC, Phillips LM, Nagler AR, Szerencsy A, Saxena A, Klapheke N, Katz SD, Horwitz LI, Blecker S. Impact of Visit Volume on the Effectiveness of Electronic Tools to Improve Heart Failure Care. JACC Heart Fail. 2024 Apr;12(4):665-674. doi: 10.1016/j.jchf.2023.11.002. Epub 2023 Nov 15.'}, {'pmid': '36882134', 'type': 'DERIVED', 'citation': 'Mukhopadhyay A, Reynolds HR, Phillips LM, Nagler AR, King WC, Szerencsy A, Saxena A, Aminian R, Klapheke N, Horwitz LI, Katz SD, Blecker S. Cluster-Randomized Trial Comparing Ambulatory Decision Support Tools to Improve Heart Failure Care. J Am Coll Cardiol. 2023 Apr 11;81(14):1303-1316. doi: 10.1016/j.jacc.2023.02.005. Epub 2023 Mar 5.'}, {'pmid': '36640860', 'type': 'DERIVED', 'citation': 'Mukhopadhyay A, Reynolds HR, Xia Y, Phillips LM, Aminian R, Diah RA, Nagler AR, Szerencsy A, Saxena A, Horwitz LI, Katz SD, Blecker S. Design and pilot implementation for the BETTER CARE-HF trial: A pragmatic cluster-randomized controlled trial comparing two targeted approaches to ambulatory clinical decision support for cardiologists. Am Heart J. 2023 Apr;258:38-48. doi: 10.1016/j.ahj.2022.12.016. Epub 2023 Jan 11.'}]}, 'descriptionModule': {'briefSummary': 'Building Electronic Tools To Enhance and Reinforce CArdiovascular REcommendations - Heart Failure (BETTER CARE-HF) is a pragmatic, cluster-randomized, three-arm intervention trial that will compare the effectiveness of two targeted clinical decision support (CDS) intervention tools (best practice alert (BPA) and automated in-basket massage) to inform providers when a patient with heart failure and reduce ejection fraction (HFrEF) is not on appropriate medical therapy, as compared to usual care.', 'detailedDescription': 'An estimated 68,000 deaths per year nationwide can be attributed to gaps in care for patients with heart failure and reduced ejection fraction (HFrEF), with the majority being due to lack of mineralocorticoid receptor antagonists (MRA). Despite proven benefits in randomized trials, class I guideline recommendations, and published clinical performance measures, patients with HFrEF are often not on guideline-directed medical therapy (GDMT). While successful interventions for improvement in prescription of GDMT have often included multidisciplinary approaches with dedicated staff, the relatively high cost of hiring additional personnel has led to an interest in electronic health record (EHR)-based interventions. Prior studies on EHR-based interventions in this arena have mainly been conducted in the inpatient setting, which is limited to one encounter during acute hospitalization, a setting often complicated by renal dysfunction or hypotension that can limit prescription of MRA. The development and study of outpatient EHR-based alerts for HFrEF GDMT are needed. Two types of outpatient EHR-based interventions include best practice alerts (BPA) and automated in-basket messages. Both of these methods have limited data, with some studies showing benefit and others demonstrating provider fatigue and burnout. To our knowledge, there is no study that has directly compared these different types of EHR-based interventions.\n\nBETTER CARE - HF is a pragmatic, cluster-randomized, three-arm intervention trail that will compare the effectiveness of two targeted CDS intervention tools (BPA and automated in-basket message) as compared to usual care on the primary outcome of MRA prescription at end of study period.'}, 'eligibilityModule': {'sex': 'ALL', 'stdAges': ['ADULT', 'OLDER_ADULT'], 'minimumAge': '18 Years', 'healthyVolunteers': False, 'eligibilityCriteria': 'Inclusion Criteria:\n\n* Cardiologist visit\n* Transthoracic echocardiogram with the most recent EF \\>= 40%\n\nExclusion Criteria:\n\n* Hypotension: SBP \\< 95\n* Hyperkalemia: most recent K \\> 5.1, or any K \\>5.5\n* Renal dysfunction: eGFR \\< 30\n* Ventricular assist device\n* Hospice care\n* Cardiac amyloid'}, 'identificationModule': {'nctId': 'NCT05275920', 'acronym': 'BETTER CARE-HF', 'briefTitle': 'Building Electronic Tools To Enhance and Reinforce CArdiovascular REcommendations - Heart Failure (BETTER CARE-HF)', 'organization': {'class': 'OTHER', 'fullName': 'NYU Langone Health'}, 'officialTitle': 'Building Electronic Tools To Enhance and Reinforce CArdiovascular REcommendations - Heart Failure (BETTER CARE-HF)', 'orgStudyIdInfo': {'id': '21-00644'}}, 'armsInterventionsModule': {'armGroups': [{'type': 'EXPERIMENTAL', 'label': 'Best Practice Alert group', 'description': "Providers will receive a BPA at the time of visit for patients with HFrEF who are not on MRA (and who do not have contraindication to MRA). This alert will display the patient's current HFrEF therapies, EF, blood pressure, potassium, and glomerular filtration rate. The alert will give access to an outpatient heart failure order set, and also provide links to the most recent guidelines.", 'interventionNames': ['Other: Best Practice Alert (BPA)']}, {'type': 'EXPERIMENTAL', 'label': 'In-Basket Message group', 'description': "Providers will receive a monthly in-basket messages linking to a list of patients who have been seen in the past 2 months or will be seen in the upcoming month with HFrEF who are not on MRA (and who do not have contraindication to MRA). This list will display each patient's current hFrEF therapies, EF, blood pressure, potassium, glomerular filtration rate, date of last visit, and date of next visit. From the list, providers can access the patient's chart, order medications, and document communication with the patient.", 'interventionNames': ['Other: In-Basket Message']}, {'type': 'NO_INTERVENTION', 'label': 'Control group', 'description': 'Patients who will receive the current standard practice of care (no BPA or in-basket message)'}], 'interventions': [{'name': 'Best Practice Alert (BPA)', 'type': 'OTHER', 'description': 'A BPA will fire in the EHR reminding care providers of the best practice when prescribing medical therapies for heart failure patients.', 'armGroupLabels': ['Best Practice Alert group']}, {'name': 'In-Basket Message', 'type': 'OTHER', 'description': 'An In-Basket message will be sent biweekly to care providers with a reminder of the best practice when prescribing medical therapies for heart failure', 'armGroupLabels': ['In-Basket Message group']}]}, 'contactsLocationsModule': {'locations': [{'zip': '10016', 'city': 'New York', 'state': 'New York', 'country': 'United States', 'facility': 'NYU Langone Health', 'geoPoint': {'lat': 40.71427, 'lon': -74.00597}}], 'overallOfficials': [{'name': 'Amrita Mukhopadhyay, MD', 'role': 'PRINCIPAL_INVESTIGATOR', 'affiliation': 'NYU Langone Health'}]}, 'sponsorCollaboratorsModule': {'leadSponsor': {'name': 'NYU Langone Health', 'class': 'OTHER'}, 'responsibleParty': {'type': 'SPONSOR'}}}}