ArticleJournal of the American College of Cardiology2023
Virtual Care Team Guided Management of Patients With Heart Failure During Hospitalization.
Article in Journal of the American College of Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed.
- Rationale and Design of the Cooperative Program for ImpLementation of Optimal Therapy in Heart Failure.Clinical cardiology · 2026Trial
- Large Language Model Recommendations for Heart Failure Therapy.Journal of cardiac failure · 2026Article
- A Pragmatic Low-Cost Digital Support Pathway for GDMT Optimization in Ambulatory HFrEF: An Exploratory 6-Month Matched Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Enhancing Guideline-Directed Medical Therapy at Discharge Through Collaborative Care: Evidence from the TIME-HF Cluster Randomized Controlled Trial.Wellcome open research · 2026Article
- The application of neighborhood area deprivation index to improve health equity across the spectrum of heart failure: a review.Heart failure reviews · 2025Review
- How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC.European journal of heart failure · 2025Review
- Improving Therapeutic Adherence and Reducing Therapeutic Inertia in the Management of People with Cardiometabolic Diseases: A Call-to-Action from the Middle East.Advances in therapy · 2025Review
- Device-based Strategies for Monitoring Congestion and Guideline-directed Therapy in Heart Failure: The Who, When and How of Personalised Care.Cardiac failure review · 2025Review
- Review
- SGLT2 Inhibitor Prescribing in Cardiovascular-Kidney-Metabolic Syndrome.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024Article
- Medication optimization clinic decreases hospitalizations and mortality for patients with heart failure with reduced ejection fraction.American heart journal plus : cardiology research and practice · 2024Article
- County-Level Variation in Triple Guideline-Directed Medical Therapy in Heart Failure With Reduced Ejection Fraction.JACC. Advances · 2024Article
- Advances in Clinical Cardiology 2023: A Summary of Key Clinical Trials.Advances in therapy · 2024Review
- Colchicine's Role in Cardiovascular Disease Management.Arteriosclerosis, thrombosis, and vascular biology · 2024Review
- Generalizable Approach to Quantifying Guideline-Directed Medical Therapy.Circulation. Heart failure · 2024Review
- Non-Pharmacological Treatment of Heart Failure-From Physical Activity to Electrical Therapies: A Literature Review.Journal of cardiovascular development and disease · 2024Review
- Digital Solutions to Optimize Guideline-Directed Medical Therapy Prescriptions in Heart Failure Patients: Current Applications and Future Directions.Current heart failure reports · 2024Review
- Telemedicine: an Effective and Low-Cost Lesson From the COVID-19 Pandemic for the Management of Heart Failure Patients.Current heart failure reports · 2023Review
- Prognosis, characteristics, and provision of care for patients with the unspecified heart failure electronic health record phenotype: a population-based linked cohort study of 95262 individuals.EClinicalMedicine · 2023Article
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53 authors.
Funding
Abstract
backgroundScalable and safe approaches for heart failure guideline-directed medical therapy (GDMT) optimization are needed.
objectivesThe authors assessed the safety and effectiveness of a virtual care team guided strategy on GDMT optimization in hospitalized patients with heart failure with reduced ejection fraction (HFrEF).
methodsIn a multicenter implementation trial, we allocated 252 hospital encounters in patients with left ventricular ejection fraction ≤40% to a virtual care team guided strategy (107 encounters among 83 patients) or usual care (145 encounters among 115 patients) across 3 centers in an integrated health system. In the virtual care team group, clinicians received up to 1 daily GDMT optimization suggestion from a physician-pharmacist team. The primary effectiveness outcome was in-hospital change in GDMT optimization score (+2 initiations, +1 dose up-titrations, -1 dose down-titrations, -2 discontinuations summed across classes). In-hospital safety outcomes were adjudicated by an independent clinical events committee.
resultsAmong 252 encounters, the mean age was 69 ± 14 years, 85 (34%) were women, 35 (14%) were Black, and 43 (17%) were Hispanic. The virtual care team strategy significantly improved GDMT optimization scores vs usual care (adjusted difference: +1.2; 95% CI: 0.7-1.8; P < 0.001). New initiations (44% vs 23%; absolute difference: +21%; P = 0.001) and net intensifications (44% vs 24%; absolute difference: +20%; P = 0.002) during hospitalization were higher in the virtual care team group, translating to a number needed to intervene of 5 encounters. Overall, 23 (21%) in the virtual care team group and 40 (28%) in usual care experienced 1 or more adverse events (P = 0.30). Acute kidney injury, bradycardia, hypotension, hyperkalemia, and hospital length of stay were similar between groups.
conclusionsAmong patients hospitalized with HFrEF, a virtual care team guided strategy for GDMT optimization was safe and improved GDMT across multiple hospitals in an integrated health system. Virtual teams represent a centralized and scalable approach to optimize GDMT.
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