A clinical reminder attached to echocardiography reports significantly increased the prescription of beta-blockers compared with no reminder (74% vs 66%, P=0.002) in patients with LVEF <45%.
RCT (n=1,546)
Yes
Does a clinical reminder attached to echocardiography reports increase the prescription of beta-blockers in patients with left ventricular ejection fraction <45%?
Attaching a clinical reminder to echocardiography reports for patients with reduced LVEF significantly increases the subsequent prescription of guideline-directed beta-blocker therapy.
Absolute Event Rate: 74% vs 66%
p-value: p=0.002
BACKGROUND: Although beta-blockers are known to prolong survival for patients with reduced left ventricular ejection fraction, they are often underused. We hypothesized that a reminder attached to the echocardiography report would increase the use of beta-blockers for patients with reduced left ventricular ejection fraction. METHODS AND RESULTS: We randomized 1546 consecutive patients with a left ventricular ejection fraction 1 laboratory (n=6). The primary outcome was a prescription for an oral beta-blocker between 1 and 9 months after randomization. The mean age of the 1271 included patients was 69 years; 60% had a history of heart failure, and 51% were receiving treatment with beta-blockers at the time of echocardiography. More patients randomized to the reminder had a subsequent beta-blocker prescription (74%, 458 of 621) compared with those randomized to no reminder (66%, 428 of 650; P=0.002). The effect of the reminder was not significantly different for subgroups based on patient location (inpatient versus outpatient) or prior use of beta-blockers. CONCLUSIONS: A reminder attached to the echocardiography report increased the use of beta-blockers in patients with depressed left ventricular systolic function.
Heidenreich et al. (Tue,) conducted a rct in Reduced left ventricular ejection fraction (n=1,546). Clinical reminder attached to echocardiography report vs. No reminder was evaluated on Prescription for an oral beta-blocker between 1 and 9 months after randomization (p=0.002). A clinical reminder attached to echocardiography reports significantly increased the prescription of beta-blockers compared with no reminder (74% vs 66%, P=0.002) in patients with LVEF <45%.