Provider Notification for High B-type Natriuretic Peptide Values

Trial of Provider Notification for Patients With High B-type Natriuretic Peptide and no Imaging to Identify Unsuspected Heart Failure.

Status

Completed

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01734135

Enrollment

115

Registered

2012-11-27

Start date

2010-10-31

Completion date

2015-09-30

Last updated

2025-09-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Heart Failure

Keywords

B type natriuretic peptide, heart failure, cardiac imaging, quality of care

Brief summary

This proposal examines use of a clinical reminder to the primary provider of patient with a high B type natriuretic peptide but no prior imaging. Electrical Medical Record-based Intervention to Determine whether Clinical Reminders Improve Heart Failure Management in Patients with High BNP Values and Unknown LVEF.

Detailed description

Rationale: B type natriuretic peptide is known to be elevated (\> 100 pg/ml) in patients with heart failure. Furthermore, treatments are available to improve survival and reduce hospitalization if the left ventricular ejection fraction (LVEF) is \< 40%. Accordingly, guidelines recommend an LVEF measure for patients with suspected heart failure. Prior work has demonstrated that patients with high BNP values do not always have a measure of left ventricular ejection. Hypothesis: A reminder to patients with BNP and no imaging may prompt providers to order appropriate imaging potentially leading to 1) identification of unsuspected depressed ejection fraction and 2) more appropriate treatment.

Interventions

OTHERClinical Reminder

A note is sent to the primary care provider using the electronic medical record indicating the high BNP result and potential benefit of measurement of the left ventricular ejection fraction. A draft order is placed for an echocardiogram for the provider to accept or delete.

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

HEALTH_SERVICES_RESEARCH

Masking

TRIPLE (Subject, Caregiver, Outcomes Assessor)

Eligibility

Sex/Gender

ALL

Age

18 Years to 120 Years

Healthy volunteers

Inclusion criteria

* BNP \>= 200 pg/ml in last 2 months

Exclusion criteria

* Measure of LVEF in the last 12 months * Last measure of LVEF \< 40%

Design outcomes

Primary

Measure	Time frame	Description
Measurement of left ventricular ejection fraction	6 months after randomization	numerator: Measurement of left ventricular ejection fraction within 6 months of randomization. denominator: All randomized patients

Secondary

Measure	Time frame	Description
Identification of LVEF < 40%	6 months following randomizaiton	Numerator: number of patients identified with an LVEF\< 40% Denominator: all randomized patients
Treatment of Low LVEF	6 months following randomization	Numerator: number of patients with an LVEF \< 40% and treatment with either an angiotensin converting enzyme inhibitor, angiotensin receptor blocker or evidence based beta-blocker (carvedilol, metoprolol succinate, bisoprolol). Denominator: all randomized patients.

Countries

United States

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026