Percentage of Patients on Beta-blocker Therapy Among Patients with Reduced Ejection Fraction
Beta-blocker therapy use among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
Median Dose of Beta-Blocker Therapy Among Patients with Reduced Ejection Fraction
Among those patients on beta-blocker therapy, the specific medication and dose will be collected.
Percentage of Patients on Renin-Angiotensin-Aldosterone System Inhibitors Among Patients with Reduced Ejection Fraction
Use of any renin-angiotensin-aldosterone system inhibitors among the sub-group of patients with left ventricular ejection fraction ≤ 40%. These include angiotensin-converting enzyme inhibitor, angiotensin receptor blockers, or angiotensin receptor-neprilysin inhibitors.
Median Dose of Renin-Angiotensin-Aldosterone System Inhibitors Among Patients with Reduced Ejection Fraction
Among those patients on renin-angiotensin-aldosterone system inhibitors with left ventricular ejection fraction ≤ 40%, the specific medication and dose will be collected.
Percentage of Patients on Mineralocorticoid Receptor Antagonist Among Patients with Reduced Ejection Fraction
Mineralocorticoid receptor antagonist use among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
Median Dose of Mineralocorticoid Receptor Antagonist Among Patients with Reduced Ejection Fraction
Among the sub-group of patients with left ventricular ejection fraction ≤ 40% on Mineralocorticoid Receptor Antagonist therapy, the specific medication and dose will be collected.
Percentage of Patients on Mineralocorticoid Receptor Antagonist Among Patients with Preserved/Mid-Range Ejection Fraction
Mineralocorticoid receptor antagonist use among the sub-group of patients with left ventricular ejection fraction > 40%.
Median Dose of Mineralocorticoid Receptor Antagonist Among Patients with Preserved/Mid-Range Ejection Fraction
Among the sub-group of patients with left ventricular ejection fraction > 40% on Mineralocorticoid Receptor Antagonist therapy, the specific medication and dose will be collected.
Percentage of Patients on Hydralazine/Nitrate Therapy Among African-American Patients with Reduced Ejection Fraction
Hydralazine/nitrate use among the subgroup of African-American patients with left ventricular ejection fraction ≤ 40%.
Median Dose of Hydralazine/Nitrate Therapy Among African-American Patients with Reduced Ejection Fraction
Among the subgroup of African-American patients with left ventricular ejection fraction ≤ 40% on hydralazine/nitrate therapy, the specific dose will be collected
Percentage of Patients on Sacubitril-Valsartan Therapy among the sub-group of patients with Reduced Ejection Fraction
Sacubitril-valsartan use among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
Median Dose of Sacubitril-Valsartan Therapy among the sub-group of patients with Reduced Ejection Fraction
Among the sub-group of patients with left ventricular ejection fraction ≤ 40% on sacubitril-valsartan, the specific dose will be collected.
Percentage of Patients on Sodium/glucose cotransporter-2 inhibitors Therapy among the sub-group of patients with preserved/mid-range ejection fraction.
Sodium/glucose cotransporter-2 inhibitors use among the sub-group of patients with left ventricular ejection fraction ≤ 40%.
Percentage of Patients on Sodium/glucose cotransporter-2 inhibitors therapy among the sub-group of patients with left ventricular ejection fraction > 40%.
Sodium/glucose cotransporter-2 inhibitors use among the sub-group of patients with left ventricular ejection fraction > 40%.
Percentage of Patients on Ivabradine Therapy Among Patients with Reduced Ejection Fraction with a Heart Rate above 70 Beats per Minute on Beta-Blocker Therapy
Ivabradine use among patients with left ventricular ejection fraction ≤ 35% and a heart rate above 70 beats per minute in sinus rhythm.
Median Dose of Ivabradine Therapy Among Patients with Reduced Ejection Fraction with a Heart Rate above 70 Beats per Minute on Beta-Blocker Therapy
Among patients with left ventricular ejection fraction ≤ 35% and a heart rate above 70 beats per minute in sinus rhythm on ivabradine, the medication dose will be collected.
Percentage of Patients with a Implantable Cardiac Defibrillator Among Patients with Reduced Ejection Fraction
Presence of an implantable cardiac defibrillator among the sub-group of patients with left ventricular ejection fraction ≤ 35%.
Percentage of Patients with a Cardiac Resynchronization Therapy Device Among Patients with Reduced Ejection
Presence of cardiac resynchronization therapy among the sub-group of patients with left ventricular ejection fraction ≤ 35% with electrocardiogram findings consistent with a left bundle branch block with QRS width >150ms.
Percentage of Patients Given Cardiac Rehabilitation Referral Among Patients with Reduced Ejection Fraction
Referral to cardiac rehabilitation among the subgroup of patients with left ventricular ejection fraction ≤ 35%.
Number of Medication Adjustments per Heart Failure Clinic Visit
The number of medication adjustments made at each heart failure clinic visit. These will include dose changes, new medications, and discontinuation of prior medicines.
Average Daily Loop Diuretic Dose
The specific loop diuretic and dose will be collected. Diuretic doses will be converted into a standard total daily dose of loop diuretic.
Count of Hospitalizations per Patient
Heart failure hospitalizations and non-heart failure hospitalizations in the Stanford healthcare system during the follow-up period.
Count of Emergency Department Visits per Patient
Stanford emergency department visits during the follow-up period.
Count of Heart Failure Clinic Visits per Patient
Stanford heart failure clinic visits during the followup period.
Count of Telephone Encounters per Patient
Stanford heart failure telephone encounters during the follow-up period.
Percentage of Patients who Undergo Formal Advanced Heart Failure Therapy Evaluation
Formal work-up for heart transplant or LVAD (left ventricular assist device) eligibility
Quality of Patient Clinic Experience
The results from a 10-question survey with ordinal responses regarding patient experience in clinic to a sub-study of all participants enrolled after the first month.
Correlation Between Clinician and Patient Perception of Health Status
Patient and clinician perception of health status will be collected. Patient perception is collected via the KCCQ-12 while clinicians will be surveyed regarding health status. We will determine the correlation between patient and clinician perception using an ordinal scale. We will compare correlation across arms.
Cardiovascular Diagnostic Test Frequency
Number of diagnostic tests performed between randomization and one year post-randomization. Diagnostic tests include cardiovascular imaging (echocardiography, MRI, cardiac CT, nuclear scan), invasive testing (coronary angiography, right heart catheterization), or ambulatory rhythm monitoring.
Kansas City Cardiomyopathy Questionnaire-12 Score Among Patients with Heart Failure or Cardiomyopathy
The first KCCQ-12 score collected one year after randomization will be compared between the KCCQ-12 and usual care arms among patients with heart failure or cardiomyopathy The first KCCQ-12 score collected one year after randomization will be compared between the KCCQ-12 and usual care arms. KCCQ-12 scores will be collected in the usual care arm starting one year after randomization. Scores will be adjusted for baseline KCCQ-12 in both arms. This will be the primary effectiveness outcome. KCCQ-12 has 4 domains (Physical Limitation Score, Symptom Frequency Score, Quality of Life Score, Social Limitation Score) and one Summary Score. Scores are scaled 0-100, where 0 denotes the lowest reportable health status and 100 the highest.
Kansas City Cardiomyopathy Questionnaire-12 Score Among Patients with Sub-optimal health status at baseline
The first KCCQ-12 score collected one year after randomization will be compared between the KCCQ-12 and usual care arms among patients with baseline KCCQ <100 at baseline
Number of Total Heart Failure Medication Adjustments
The total number of heart failure medication adjustments. Heart failure medications include beta-blockers, renin-angiotensin-aldosterone system inhibitors, mineralocorticoid receptor antagonists, sodium/glucose cotransporter-2 inhibitors, hydralazine/nitrate therapy, ivabradine, or loop diuretics.