Stratified approach to medical optimisation in chronic heart failure
Research type
Research Study
Full title
Exploring factors contributing to failure to achieve or maintain optimal doses of beta-blockers in chronic heart failure: a missed opportunity to improve patient outcomes?
IRAS ID
271962
Contact name
Klaus Witte
Contact email
Sponsor organisation
University of Leeds
Duration of Study in the UK
3 years, 11 months, 31 days
Research summary
Heart failure is a common condition associated with poor quality of life, recurrent hospitalisations and shortened longevity. Guideline-directed medical therapy reduces the risks of adverse outcomes, but some patients cannot tolerate optimal doses due to low blood pressure, low heart rate or kidney dysfunction. \n \nWe have previously shown that patients with newly diagnosed heart failure who fail to achieve high doses of the recommended tablets at one year are at much higher risk of adverse outcomes. However, our data have also shown that half of these patients did not have clear medical reasons for not achieving the highest doses of the tablets. In other words they did not have low blood pressure or a low heart rate.\n\nWe want to find out whether we can identify early on, at the time of their diagnosis (at the start of the treatment pathway) which patients are more likely not to achieve optimal doses at one year, and why, with a view to eventually providing them with more support and thereby a better chance of optimal doses and a good outcome. \n\nThis study will enrol 250 patients with newly diagnosed heart failure. We will collect baseline information about their condition, other conditions they have, their cognitive function, their social support and their knowledge of heart failure.\n\nWe will then see them at one year to review their condition, their treatment, their knowledge, and cognitive function and record any events to try and see if we could have predicted dose achievement from the baseline information.
REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
19/YH/0422
Date of REC Opinion
21 Nov 2019
REC opinion
Favourable Opinion