Table 1.
Examples of randomized controlled trials of heart failure transitional-care interventions
| Trial | Population | Description of intervention | Main outcomes | Notes |
|---|---|---|---|---|
| PACT-HF (Patient-Centered Care Transitions in HF) [55] | Ontario hospitals (n = 10, including 2494 patients whose reason for hospitalization was HF) | A transitional-care model that combined evidence-informed services with guideline recommendations and a patient-centered approach | No differences versus usual care in time to all-cause readmission or emergency department visit at 30 days after hospitalization | Pragmatic trial; randomization was at the hospital level; the intervention improved the exploratory outcomes of quality of care and discharge preparedness |
| CONNECT-HF (Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure) [56] | American hospitals (n = 161, including 5647 adults with HF with reduced ejection fraction) | A quality improvement intervention (versus usual care) designed to improve transition processes and guideline-directed medical therapy in people living with HF | The intervention did not result in better measures of quality of care or clinical outcomes | Randomization was at the hospital level |
| EPIC-HF (Electronically Delivered, Patient-Activation Tool for Intensification of Medications for Chronic Heart Failure with Reduced Ejection Fraction) [57] | Adults with HF with reduced ejection fraction (n = 290) from the University of Colorado Health system | A patient activation tool (versus usual care) comprising a short video and single-page medication checklist; the tool encourages people living with HF to work collaboratively with their clinicians | The intervention was effective in improving guideline-directed medical therapies | – |
| REACH-HF (Rehabilitation Enablement in Chronic Heart Failure) [58] | Adults with HF with reduced ejection fraction (n = 216) | A self-care, home-based, facilitated cardiac rehabilitation manual (versus usual care) offered over 12 weeks by trained health care professionals, plus usual care | There was a clinically meaningful difference in the Minnesota Living with Heart Failure Questionnaire score at 1 year (−5.7 points, 95% confidence interval −10.6 to −0.7 points) favoring the REACH-HF intervention (P = 0.025) | There was no significant difference in hospital admissions at 1 yr |
HF, heart failure
The trials shown in this table were selected to serve as examples of recently published randomized controlled trials that illustrate some of the benefits and limitations of existing approaches to HF transitional care, and do not represent an exhaustive list