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Completed

NCT Number: NCT05602454

Virtual Care to Improve Heart Failure Outcomes (VITAL-HF)

The purpose of this study is to evaluate how safe and effective a remote, digital intervention is that helps clinicians use and optimally adjust heart failure medications, compared to usual care medication use and adjustment, in participants with heart failure with reduced ejection fraction

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Key information

Conditions

Heart Failure With Reduced Ejection Fraction

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Cardiovascular Institute of Northwest Florida, Panama City, Florida, United States

Loading trial locations.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Age >18 years of age
  • Diagnosis of HF and LVEF <40% on most recent imaging assessment within 1 year prior to screening. Any validated method for assessing LVEF may be used for enrollment including echocardiogram, cardiac magnetic resonance imaging, etc. For participants with an LVEF reported qualitatively (e.g., moderate LV dysfunction) or as a range on the most recent imaging assessment that includes 40% (e.g., 35-45%), then the site investigator should review the imaging study and determine if the participant has an LVEF <40%. Participants with a new diagnosis of HFrEF may be enrolled. The enrollment will be monitored to ensure no more than 50% of the total cohort have new-onset HFrEF.
  • Access to a smartphone including through a family member of caregiver
  • Fluent in written and spoken English

Exclusion criteria

  • Optimized or nearly-optimized on evidence-based medical therapies for HFrEF as determined by local investigator.
  • Current pregnancy
  • Chronic use of intravenous inotropic medications including milrinone, dobutamine, or dopamine
  • eGFR of <20 mL/min/1.73m2 or ongoing chronic dialysis at screening
  • Prior heart transplant
  • Current or planned left ventricular assist device
  • Currently receiving hospice care
  • Chronically resides in an assisted living or skilled nursing facility where food and medications are managed by facility personnel
  • Terminal illness other than HF with a life expectancy of less than 1 year as determined by the enrolling clinician-investigator

Treatment and study plan

Digital Heart Failure Medication Titration

Other

Story Health Platform, which is a remote, digital tool that provides treating clinicians collected data to make clinical decisions regarding heart failure medication titration.

Primary outcomes

  1. Change in medical therapy, as measured by the Heart Failure Medical Therapy Score

    Time frame: Baseline, 6 months

    Scores are 0-3 for 7 key medication classes for heart failure with reduced ejection fraction where 0 represents no use of the medication class

Secondary outcomes

  1. Change in medical therapy, as measured by the Kansas City Medical Optimization score

    Time frame: Baseline, 6 months

    Scores are the average of the total daily dose to target dose values for HF medications. Scores range from 0-100.

  2. Intensification of evidence-based medical therapies, measured by number of participants with reported changes.

    Time frame: baseline, 6 months

    Proportion of participants with any intensification of and cumulative number of intensifications of evidence-based medical therapies for HFrEF from baseline to last follow-up.

  3. Proportion of participants on 50% of published target doses of evidence-based medical therapies for HFrEF at last follow-up.

    Time frame: 6 months

    The last measure dose will be compared with the target dose in the 2022 Heart Failure Guidelines.

  4. Proportion of participants on 100% of published target doses of evidence-based medical therapies for HFrEF at last follow-up.

    Time frame: 6 months

    The last measure dose will be compared with the target dose in the 2022 Heart Failure Guidelines.

  5. Combined Emergency department visits and hospitalizations, as measured by number of subjects with at least one occurrence

    Time frame: 3 months, 6 months

    Combined Emergency department visits and hospitalizations related to evidence-based medical therapies for HFrEF including symptomatic hypotension, hyperkalemia, and angioedema

Other outcomes

  1. Change in participant-reported medication adherence using the Voils score

    Time frame: Baseline, 6 months

    The Voils score includes questions used to assess medication adherence. Answers range between "not at all" and "very much", with 3 options in between. "Not at all" means a dose was not missed and "Very much" means dose was missed for that reason.

  2. Change in Kansas City Cardiomyopathy Questionnaire Overall Summary score

    Time frame: Baseline, 6 months

    The Kansas City Cardiomyopathy Questionnaire 12-item version includes multiple domains: symptom frequency, quality of life, social limitation, and physical limitation. The Overall Summary score incorporates the averages of these 4 domains and is reported on a 0-to-100-point scale, where lower scores represent more severe symptoms and/or limitations and scores of 100 indicate no symptoms, no limitations, and excellent quality of life.

  3. Global rank score across 3 hierarchical tiers of a composite outcome: time to death, time to HF hospitalization, change from baseline to last follow-up in the HF medical therapy score

    Time frame: baseline, 6 months

  4. Composite of all-cause death and total worsening HF events defined by hospitalizations for acute HF and urgent HF events

    Time frame: 3 months, 6 months

  5. Worsening HF events defined by hospitalizations for acute HF and urgent HF events

    Time frame: 3 months, 6 months

  6. All-cause hospitalizations

    Time frame: 3 months, 6 months

Sponsors and collaborators

Lead sponsor

Duke University

Other

Collaborators

  • Story Health Inc.

Registry information

Official study title

Virtual Care to Improve Heart Failure Outcomes (VITAL-HF) Randomized Controlled Trial

Important dates

Study start
2022
Primary completion
2025
Study completion
2025
First posted
Nov 2, 2022
Registry last updated
Jul 23, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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