COPILOT-HF: Cooperative Program for ImpLementation of Optimal Therapy in Heart Failure (COPILOT-HF)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The primary objectives are:
- Determine if a remote, or virtual, clinic that implements a standardized, stepped-approach to guideline-directed medication optimization in patients with heart failure (across the spectrum of ejection fraction), will achieve a higher rate of guideline-directed medical therapy (GDMT) than a strategy of patient and provider education followed by remote heart failure clinic management.
- In eligible patients with LVEF<50%, determine if the sequencing of GDMT initiation (traditional vs. sodium-glucose co-transporter-2 inhibitors-first) leads to improved GDMT intensification
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Daniel Gabovitch, MGB
- Phone Number: 6177633692
- Email: dgabovitch@bwh.harvard.edu
Study Contact Backup
- Name: Alexander Blood, MD, MSc
- Phone Number: 617-732-7144
- Email: ablood@bwh.harvard.edu
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02115
- Brigham and Women's Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Documented diagnosis of heart failure (e.g., ICD-9 codes 428 ICD-10 codes I50 or Problem list in the electronic health record)
- Most recent EF assessed within the past 24 months
- Seen Mass General Brigham provider within the last 24 months
- English or Spanish speaking
Exclusion Criteria:
- LVEF<50% currently prescribed or intolerant to both ARNi and SGLT2i
- LVEF>50% currently prescribed or intolerant to SGLT2i
- Systolic blood pressure (SBP) <90 mmHg at last measure
- Current severe aortic stenosis or severe aortic insufficiency
- Known amyloid heart disease
- Group 1 pulmonary arterial hypertension on disease-specific therapies (e.g., Ambrisentan, Bosentan, Epoprostenol, Treprostinil, Iloprost)
- eGFR<30 mL/min/1.73m2
- Active chemotherapy
- Receiving end-of-life care or hospice
- History of transplant, currently listed above status 4 or being evaluated for transplant
- Outpatient intravenous inotrope use
- Current use of a Ventricular Assist Device
- Physician's discretion as inappropriate for remote management program
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Sequential Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Medication & Education-First
Patient will immediately begin participation in a remote, pharmacist-driven heart failure clinic that will initiate and titrate medications according to a standardized medical algorithm.
|
Immediate initiation of guideline-directed medical therapy.
Will also immediately receive the same educational services provided in the "Education-First" intervention.
|
|
Active Comparator: Education-First
Patient will first receive curated patient education, an alert to providers, and provider education, and then after 3 months begin participation in the remote heart failure clinic.
|
Immediate initiation of guideline-directed medical therapy.
Will also immediately receive the same educational services provided in the "Education-First" intervention.
For the first 3-months of their participation, patients in this arm will receive curated patient education, an alert to providers, provider education, and then after 3 months, be invited to participate in the remote heart failure clinic.
The patient education would consist of curated video content and informational worksheets provided by email or secure patient messaging.
Provider alerts would happen through notifying of a patient's eligibility for heart failure therapy.
Provider education will also consist of the program's medical algorithm and a summary sheet on indications, outcomes, prescribing, and monitoring information
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Primary Endpoint
Time Frame: 3-months following randomization
|
The percent of eligible enrolled patients who achieve utilization of recommended therapy for heart failure at 3 months after randomization, which includes: • In patients with EF<50%, utilization of 4 drug classes (ARNI/ARB/ACEI, SGLT2i, BB, and MRA), OR • In patients with EF ≥50%, utilization of SGLT2i. |
3-months following randomization
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Secondary Endpoint
Time Frame: 6-months following randomization
|
Any Intensification of guideline-directed medical therapy, which includes any initiation or titration of a GDMT medication.
|
6-months following randomization
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Heart Diseases
- Heart Failure
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Neurotransmitter Agents
- Adrenergic Agents
- Adrenergic Antagonists
- Investigative Techniques
- Pharmacologic Actions
- Chemical Actions and Uses
- Physiological Phenomena
- Pharmacological and Toxicological Phenomena
- Toxicity Tests
- Toxicological Phenomena
- Adrenergic beta-Antagonists
- tocilizumab
- Maximum Tolerated Dose
Other Study ID Numbers
Other Study ID Numbers
- 2022P002809
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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