Digital heart failure management: Insights from the COPILOT study

Q: What are the key findings of this study?

A simultaneous remote management and education program increased the rate of heart failure patients achieving full guideline-directed medical therapy at 3 months versus education alone.

Q: What is the clinical evidence from this study?

Study design: Review. Population: Heart failure (n=503). Intervention: Simultaneous remote GDMT optimization and education vs. Education-first strategy. Primary outcome: Proportion of participants receiving full GDMT at 3 months (p=<0.001).

Jonas M. Rolland; Tarjei Øvrebotten; Kevin Damman; Stephen J. Greene; Peder L Myhre

doi:10.1007/s10741-026-10633-3

April 18, 2026Heart Failure ReviewsOpen Access

Digital heart failure management: Insights from the COPILOT study

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Key result

Remote HF management achieves full GDMT in ~32% of patients versus none with education alone.

P<0.001
n=503

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Why the study?

Suboptimal implementation of guideline-directed medical therapy remains a major problem in heart failure care.

Does a remote pharmacist-led, navigator-assisted program improve the proportion of patients receiving full guideline-directed medical therapy in adults with heart failure?

Structured PICO

Does a remote pharmacist-led, navigator-assisted program improve the proportion of patients receiving full guideline-directed medical therapy in adults with heart failure?

P

Population

503 adults aged 18-90 with documented heart failure (regardless of LVEF, symptomatic within 2 years), mean age 72, 52% male. Key exclusions: hypotension, type 1 diabetes, known use or intolerance of SGLT2i or ARNI, severe aortic valve disease, kidney failure, amyloid heart disease, and pulmonary arterial hypertension requiring treatment.

I

Intervention

Simultaneous initiation of a remote pharmacist-led, navigator-assisted heart failure management program for GDMT optimization and education

C

Comparator

Education-first approach (provider and patient education alone for 3 months)

O

Outcome

Proportion of participants receiving full GDMT at 3 months

Main Result

Absolute Event Rate: 32% vs 0%

p-value: p=<0.001

Limitations

Applicability in broader settings remains uncertain due to differences in pharmacist roles across countries.
The data do not provide information about reasons for underutilization of GDMT, such as side effects or contraindications.
Detailed data on safety outcomes remain to be published.
Two-thirds of patients in the intervention group did not achieve optimal GDMT.
Two-thirds of patients in the intervention group did not achieve optimal GDMT
Detailed data on safety outcomes remain to be published
Differences in pharmacist roles outside the US may limit generalizability
Lack of data on reasons for underutilization of GDMT (e.g., side effects or contraindications)

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Implication

A remote pharmacist-led, navigator-assisted program significantly improved the rapid implementation of guideline-directed medical therapy in heart failure patients compared to education alone.

Abstract

Suboptimal implementation of guideline-directed medical therapy (GDMT) remains a major problem in heart failure (HF) care. The Cooperative Program for Implementation of Optimal Therapy in Heart Failure (COPILOT-HF) trial evaluated an innovative remote strategy to optimize GDMT across the spectrum of HF, irrespective of left ventricular ejection fraction (LVEF). This pragmatic randomized study compared a pharmacist-led, navigator-assisted remote program against traditional provider notification and education. The results, recently presented at the American Heart Association 2025 Scientific Sessions, offer compelling insights into overcoming clinical inertia and improving HF management in the digital age. This mini review examines the trial’s key findings and their potential to reshape HF care delivery.

Cite This Study

Rolland et al. (2026) conducted a review in Heart failure (n=503). Simultaneous remote GDMT optimization and education vs. Education-first strategy was evaluated on Proportion of participants receiving full GDMT at 3 months (p=<0.001). A simultaneous remote management and education program increased the rate of heart failure patients achieving full guideline-directed medical therapy at 3 months versus education alone.

synapsesocial.com/papers/69e5c38303c293991402947b https://doi.org/10.1007/s10741-026-10633-3

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Digital heart failure management: Insights from the COPILOT study

Figures

Structured PICO

Main Result

Limitations

Ask about this paper

Discussion

Implication

Abstract

Cite This Study

Digital heart failure management: Insights from the COPILOT study

Figures

Structured PICO

Main Result

Limitations

Ask about this paper

Discussion

Implication

Abstract

Cite This Study

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