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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

Author

Listed:
  • Leonardo Graever

    (Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21044-020, Brazil
    Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark)

  • Aurora Felice Castro Issa

    (Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil)

  • Viviane Belidio Pinheiro da Fonseca

    (Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil)

  • Marcelo Machado Melo

    (Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil)

  • Gabriel Pesce de Castro da Silva

    (Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil)

  • Isabel Cristina Pacheco da Nóbrega

    (Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Brazil)

  • Leonardo Cançado Monteiro Savassi

    (Departamento de Medicina de Família, Saúde Mental e Coletiva, Universidade Federal de Ouro Preto, Minas Gerais 35400-000, Brazil)

  • Mariana Borges Dias

    (Ministry of Health, Brasilia 70058-900, Brazil)

  • Maria Kátia Gomes

    (Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21044-020, Brazil)

  • Jose Roberto Lapa e Silva

    (Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21044-020, Brazil)

  • Raphael Mendonça Guimarães

    (Escola Nacional de Saúde Pública, Rio de Janeiro 21041-210, Brazil)

  • Renato Cony Seródio

    (Secretaria Municipal de Saúde, Rio de Janeiro 20211-110, Brazil)

  • Anne Frølich

    (Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1353 Copenhagen, Denmark)

  • Henrik Gudbergsen

    (Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, 1353 Copenhagen, Denmark)

  • Janus Christian Jakobsen

    (Copenhagen Trial Unit, Centre for Clinical Intervention Research, Capital Region of Denmark & Department of Regional Health Research, The Faculty of Health Sciences, University of Southern Denmark, 2200 Copenhagen, Denmark)

  • Helena Dominguez

    (Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark)

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.

Suggested Citation

  • Leonardo Graever & Aurora Felice Castro Issa & Viviane Belidio Pinheiro da Fonseca & Marcelo Machado Melo & Gabriel Pesce de Castro da Silva & Isabel Cristina Pacheco da Nóbrega & Leonardo Cançado Mon, 2023. "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 Telemed," IJERPH, MDPI, vol. 20(11), pages 1-16, May.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:11:p:5933-:d:1154188
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    References listed on IDEAS

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    1. Mayara Lisboa Bastos & Dick Menzies & Thomas Hone & Kianoush Dehghani & Anete Trajman, 2017. "The impact of the Brazilian family health on selected primary care sensitive conditions: A systematic review," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-14, August.
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