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. 2023 May 24;20(11):5933.
doi: 10.3390/ijerph20115933.

Telemedicine Support for Primary Care Providers versus Usual Care in Patients with Heart Failure: Protocol of a Pragmatic Cluster Randomised Trial within the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) Study

Leonardo Graever  1   2 , Aurora Felice Castro Issa  3 , Viviane Belidio Pinheiro da Fonseca  3 , Marcelo Machado Melo  3 , Gabriel Pesce de Castro da Silva  3 , Isabel Cristina Pacheco da Nóbrega  3 , Leonardo Cançado Monteiro Savassi  4 , Mariana Borges Dias  5 , Maria Kátia Gomes  1 , Jose Roberto Lapa E Silva  1 , Raphael Mendonça Guimarães  6 , Renato Cony Seródio  7 , Anne Frølich  8 , Henrik Gudbergsen  8 , Janus Christian Jakobsen  9 , Helena Dominguez  2
Affiliations

Telemedicine Support for Primary Care Providers versus Usual Care in Patients with Heart Failure: Protocol of a Pragmatic Cluster Randomised Trial within the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) Study

Leonardo Graever et al. Int J Environ Res Public Health. .

Abstract

Heart failure is a prevalent condition and a frequent cause of hospital readmissions and poor quality of life. Teleconsultation support from cardiologists to primary care physicians managing patients with heart failure may improve care, but the effect on patient-relevant outcomes is unclear. We aim to evaluate whether collaboration through a novel teleconsultation platform in the Brazilian Heart Insufficiency with Telemedicine (BRAHIT) project, tested on a previous feasibility study, can improve patient-relevant outcomes. We will conduct a parallel-group, two-arm, cluster-randomised superiority trial with a 1:1 allocation ratio, with primary care practices from Rio de Janeiro as clusters. Physicians from the intervention group practices will receive teleconsultation support from a cardiologist to assist patients discharged from hospitals after admission for heart failure. In contrast, physicians from the control group practices will perform usual care. We will include 10 patients per each of the 80 enrolled practices (n = 800). The primary outcome will be a composite of mortality and hospital admissions after six months. Secondary outcomes will be adverse events, symptoms frequency, quality of life, and primary care physicians' compliance with treatment guidelines. We hypothesise that teleconsulting support will improve patient outcomes.

Keywords: clinical competence; cluster randomized trial; heart failure; primary health care; telemedicine.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the study’s design; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
Study workflow.
See this image and copyright information in PMC

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