IMPROVE HF: Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting
IMPROVE-HF
Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting
1 other identifier
observational
34,810
1 country
144
Brief Summary
The purpose of this study is to characterize current management of patients with either heart failure or prior myocardial infarction and left ventricular dysfunction and to assess the effect of education, specific clinical guidelines, reminder systems, comprehensive disease state management tools, benchmarked quality reports, and academic detailing on the use of evidence-based heart failure therapies in cardiology practices. This study is a quality improvement initiative that is being conducted through review of patient records.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for all trials
Started May 2005
Longer than P75 for all trials
144 active sites
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
Study Start
First participant enrolled
May 1, 2005
CompletedFirst Submitted
Initial submission to the registry
March 15, 2006
CompletedFirst Posted
Study publicly available on registry
March 17, 2006
CompletedPrimary Completion
Last participant's last visit for primary outcome
August 1, 2009
CompletedStudy Completion
Last participant's last visit for all outcomes
August 1, 2009
CompletedResults Posted
Study results publicly available
December 27, 2012
CompletedJanuary 31, 2019
January 1, 2019
4.3 years
March 15, 2006
November 21, 2012
January 29, 2019
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
To Evaluate Over the Aggregate IMPROVE-HF Practice Sites the Relative Changes in 7 Performance Measures at 24 Months Compared With Baseline and Determine the Number of Performance Measures That Achieved a Relative 20% or Greater Positive Change.
7 performance measures: angiotensin converting enzyme inhibitor and/or angiotensin II receptor blockers (ACEI/ARB), beta-blokers, aldosterone receptor antagonists, anticoagulation for atrial fibrillation (AF), cardiac resynchronization therapy (CRT-P/CRT-D), cardioverter-defibrillator (ICD/CRT-D), heart failure (HF) education. We first calcuated % of patients who were eligible for a performance measure that were treated by it at baseline and 24 months. We then calculated the relative change as (% treated at 24 months - % treated at baseline)/% treated at baseline. The 95% confidence interval (CI) was calculated and the relative change of each performance measure was evaluated using a z-test for one-sample proportion. The number of performance measures with \>= 20% relative improvement was determined. The intervention was considered successful if a relative 20% or greater improvement in at least 2 of the 7 performance measures at 24 months compared with baseline was achieved.
24 Month
Secondary Outcomes (4)
Observe the Number of Sites That Demonstrate a Relative 20% or Greater Improvement in 2 or More of the 7 Performance Measures at 24 Months as Compared to Baseline in Cohort A.
24 months
Observe the Change From Baseline to 24 Months in Each Performance Measure and Composite Score for the Aggregate Practices.
24 months
Observe the Relative Change Between Baseline of Cohort A and 6 Months of Cohort B in Performance Measures and Composite Score for the Aggregate Practices.
Baseline and 6 Months
Observe the Relative Change Between Baseline of Cohort A and 18 Months of Cohort C in Performance Measures and Composite Score for the Aggregate Practices.
baseline and 18 Months
Study Arms (3)
Cohort A (longitudinal)
Longitudinal Cohort: Approximately 15,000 patients followed at baseline, 12 months and 24 months
Cohort B (6 Month)
6 Month Cohort: Approximately 10,000 patients reviewed at single time point
Cohort C (18 Month)
18 Month Cohort: Approximately 10,000 patients reviewed at single time point
Eligibility Criteria
Heart failure patients in outpatient cardiology practices
You may qualify if:
- years of age or older
- Primary or secondary diagnosis of heart failure or prior myocardial infarction (heart attack)
- Moderate-to-severe left ventricular dysfunction (LVD) as demonstrated by an ejection fraction \< or = 35% and/or a qualitative assessment of LVD of moderate-to-severe or severe LVD
- Patient has been seen at the clinic at least twice in the past 2 years
- Patient received care from the physician participating in the study
You may not qualify if:
- Patient has died
- Patient is not expected to survive for 12 months due to medical conditions other than heart failure
- Patient has undergone heart transplant surgery
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Medtronic Cardiac Rhythm and Heart Failurelead
- Medtroniccollaborator
Study Sites (144)
Cardiovascular Associates of Montclair
Birmingham, Alabama, 36608, United States
Cardiology Associates
Mobile, Alabama, 36608, United States
Cardiovascular Associates of Mesa
Mesa, Arizona, 85205, United States
Heart Care, PC
Scottsdale, Arizona, 85258, United States
Southern Arizona VA Health Care System
Tucson, Arizona, 85723, United States
Central Arkansas Cardiovascular Institute
Hot Springs, Arkansas, 71913, United States
Arkansas Cardiology Clinic
Little Rock, Arkansas, 72202, United States
St. Jude Heritage Medical Group
Fullerton, California, 92835, United States
Scripps Clinic Green Hospital
La Jolla, California, 92037, United States
Veterans Administration Hospital
Los Angeles, California, 92357, United States
University Cardiovascular Medical Group
Los Angeles, California, 94115, United States
Cardio-Pulmonary Associates
Monterey, California, 93940, United States
Temecula Valley Cardiology
Murrieta, California, 92562, United States
California Pacific Cardiovascular Medical
San Francisco, California, 94115, United States
East Bay Cardiology
San Pablo, California, 94803, United States
Cardiology Consultants Medical Group
Tarzana, California, 91335, United States
Medical Center of the Rockies
Fort Collins, Colorado, 80521, United States
Connecticut Heart & Vascular Center
Bridgeport, Connecticut, 06606, United States
Cardiology Consultants, PA
Newark, Delaware, 19702, United States
Heart and Vascular Center of Bradenton
Bradenton, Florida, 34209, United States
Clearwater Cardiovascular & Intervention
Clearwater, Florida, 33756, United States
Mahesh Amin, MD PA
Clearwater, Florida, 33756, United States
Pasco Cardiology
Hudson, Florida, 34667, United States
Cardiovascular Associates
Kissimmee, Florida, 34741, United States
Clark and Daughtrey Medical Group
Lakeland, Florida, 33803, United States
OMNI
Melbourne, Florida, 32901, United States
Miami Cardiology Group
Miami, Florida, 33176, United States
Florida Heart Group
Orlando, Florida, 32803, United States
Cardiology Associates
Port Charlotte, Florida, 33952, United States
Cardiovascular Consultants,
Tamarac, Florida, 33309, United States
Indian River Cardiovascular Associate
Vero Beach, Florida, 32960, United States
Florida Medical Clinic
Zephyrhills, Florida, 33542, United States
Cardiology of Atlanta
Atlanta, Georgia, 30342, United States
Northside Cardiology
Atlanta, Georgia, 30342, United States
Northeast Georgia Heart Center
Gainesville, Georgia, 30501, United States
Southcoast Cardiology
Savannah, Georgia, 31406, United States
Pacific Cardiology
Honolulu, Hawaii, 96817, United States
St. Luke's Idaho Cardiology Associates
Boise, Idaho, 83702, United States
Heart Care Center of Illinois
Blue Island, Illinois, 60406, United States
MidAmerica Cardiovascular Consultants
Frankfort, Illinois, 60453, United States
Cardiovascular Associates of Glenbrook and Evanston, LLC
Glenview, Illinois, 60026, United States
St. Vincent's Hospital
Indianapolis, Indiana, 46201, United States
Methodist Hospital
Indianapolis, Indiana, 46202, United States
St. Vincent's Hospital Indianapolis
Indianapolis, Indiana, 46278, United States
St. Vincent's Hospital,
Indianapolis, Indiana, 46278, United States
Iowa Heart Center PC,
West Des Moines, Iowa, 50266, United States
Mid America Cardiology
Kansas City, Kansas, 66102, United States
Cardiology Consultants
Topeka, Kansas, 66102, United States
Cardiovascular Consultants of Kansas
Wichita, Kansas, 67226, United States
Louisville Cardiology Medical Group P.S
Louisville, Kentucky, 40026, United States
Medical Center Cardiologists P.S.C
Louisville, Kentucky, 40201, United States
Louisville Cardiology Medical Group P.S
Louisville, Kentucky, 40207, United States
Owensboro Heart and Vascular
Owensboro, Kentucky, 42303, United States
Tchefuncte Cardiovascular Associates,
Covington, Louisiana, 70433, United States
Heart Clinic of Louisiana
Marrero, Louisiana, 70072, United States
Maryland Heart, PC
Bethesda, Maryland, 20817, United States
Heart Center of Southern Maryland
Clinton, Maryland, 20735, United States
Arundel Heart Associates
Glen Burnie, Maryland, 21061, United States
Peninsula Cardiology
Salisbury, Maryland, 21804, United States
Primary Care Specialists Inc
Ayer, Massachusetts, 01432, United States
Merrimack Valley Cardiology
Chelmsford, Massachusetts, 01824, United States
Harbor Medical AssociatesSo Weymouth
Weymouth, Massachusetts, 02190, United States
Consultants in Cardiology
Farmington Hills, Michigan, 48331, United States
Cardiovascular Consultants PC
Rochester, Michigan, 48312, United States
Eastside Cardiology, Roseville
Roseville, Michigan, 48066, United States
St. Paul Cardiology
Saint Paul, Minnesota, 55102, United States
University of Mississippi Medical Center
Jackson, Mississippi, 39216, United States
Missouri Cardiovascular Specialists
Columbia, Missouri, 65201, United States
University Hospital Healthcare
Columbia, Missouri, 65210, United States
Freeman Heart Institute
Joplin, Missouri, 64804, United States
Mercy Cardiology
St Louis, Missouri, 63101, United States
Cardiology Diagnostics, Ltd,
St Louis, Missouri, 63131, United States
Cardiac Associates of New Hampshire
Concord, New Hampshire, 03303, United States
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03756, United States
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03766, United States
Medicor
Bridgewater, New Jersey, 08807, United States
Cross County Cardiology
Edgewater, New Jersey, 07020, United States
Heart-Lung Center
Hawthorne, New Jersey, 07506-1919, United States
Southern New Jersey Cardiac Specialists
Voorhees Township, New Jersey, 08043, United States
Diagnostic and Clinical Cardiologists
West Orange, New Jersey, 07052, United States
Westwood Cardiology
Westwood, New Jersey, 07675, United States
Albany Associates in Cardiology,
Albany, New York, 12205, United States
SUNY Downstate Medical Center
Brooklyn, New York, 11203, United States
Cardiology Associates of Brooklyn
Brooklyn, New York, 11219, United States
United Medical Associates
Brooklyn, New York, 11219, United States
Concorde Medical Group/NYU Hospital
Manhattan, New York, 10001, United States
Island Cardiac Specialists
Mineola, New York, 11501, United States
Island Cardiac Specialist
Mineola, New York, 11501, United States
Gotham Cardiovascular Research
New York, New York, 10001, United States
Westchester Medical Group
Scarsdale, New York, 10583, United States
Vazzana and Bogin Cardiology Associates
Staten Island, New York, 10305, United States
Cardiology PC
Syracuse, New York, 13210, United States
Southbay Cardiology
West Islip, New York, 11795, United States
Asheville Cardiology Associates
Asheville, North Carolina, 28803, United States
Sanger Clinic
Charlotte, North Carolina, 28202, United States
Carolina Heart Specialists
Gastonia, North Carolina, 28054, United States
Southeastern Heart and Vascular
Greensboro, North Carolina, 27403, United States
Hickory Cardiology
Hickory, North Carolina, 28602, United States
Carolina Cardiology Associates
High Point, North Carolina, 27262, United States
Heart Center of Eastern Carolina,
New Bern, North Carolina, 28562, United States
Heart Center of Eastern Carolina
New Bern, North Carolina, 28562, United States
Pinehurst Cardiology Consultants
Pinehurst, North Carolina, 28370, United States
Pinehurst Cardiology Consultants
Pinehurst, North Carolina, 28374, United States
Raleigh Cardiology
Raleigh, North Carolina, 27610, United States
Meritcare Medical Center
Fargo, North Dakota, 58122, United States
Northeast Ohio Cardiovascular Specialists
Akron, Ohio, 44301, United States
Muhammed H. Zahra
Cleveland, Ohio, 44125, United States
Cleveland Clinic Foundation
Cleveland, Ohio, 44195, United States
Doctors Hospital Heart Failure Clinic
Columbus, Ohio, 43228, United States
Schuster Cardiology Associates
Kettering, Ohio, 45336, United States
The Heart Institute of Northwest Ohio
Lima, Ohio, 45801, United States
Bryce Morrice MD and Debra Heldman MD Inc
Newark, Ohio, 43055, United States
Cardiovascular Clinic, Inc.
Parma, Ohio, 44129, United States
North West Ohio Cardiology Consultants
Toledo, Ohio, 43615, United States
Abington Medical Specialists
Abington, Pennsylvania, 19001, United States
Geisinger Medical Center
Danville, Pennsylvania, 17822, United States
Central Bucks Specialists, Ltd.,
Doylestown, Pennsylvania, 18901, United States
Associated Cardiologists
Harrisburg, Pennsylvania, 17103, United States
The Heart Group, Ltd
Lancaster, Pennsylvania, 17603, United States
Drexel University College of Medicine
Philadelphia, Pennsylvania, 19129, United States
Cardiology Associates of Southeastern PA
Wynnewood, Pennsylvania, 19064, United States
York Hospital
York, Pennsylvania, 17403, United States
Blackstone Cardiology Associates
Pawtucket, Rhode Island, 02860, United States
Medical University of South
Charleston, South Carolina, 29406, United States
Upstate Cardiology
Greenville, South Carolina, 29605, United States
Cardiology Associates
Myrtle Beach, South Carolina, 29572, United States
Cardiology Consultants, PA
Spartanburg, South Carolina, 29301, United States
Sumter Medical Consultants
Sumter, South Carolina, 29150, United States
Columbia Cardiology Consultants
West Columbia, South Carolina, 29204, United States
Sutherland Clinic
Germantown, Tennessee, 38119, United States
Dela Clinic
Lexington, Tennessee, 38351, United States
Heart Place North Arlington
Arlington, Texas, 75284, United States
University of Texas South Western Medical Center at Dallas
Dallas, Texas, 75201, United States
Comprehensive Heart Care, PA
Houston, Texas, 77024, United States
Cardiology Consultants of Houston
Houston, Texas, 77030, United States
Legacy Heart Center
Plano, Texas, 75024, United States
Cardiology Clinic of San Antonio
San Antonio, Texas, 78229, United States
Wilford Hall Medical Center
San Antonio, Texas, 78229, United States
Tyler Cardiovascular Consultants
Tyler, Texas, 75701, United States
University Associates in Cardiology
Burlington, Vermont, 05401, United States
Cardiology Associates of Lakeview
Fairfax, Virginia, 05454, United States
The Cardiovascular Group
Fairfax, Virginia, 22031, United States
Tidewater Heart Specialists, Inc.,
Hampton, Virginia, 23666, United States
Cardiology Associates of Green Bay
Green Bay, Wisconsin, 54301, United States
Related Publications (10)
Shukla A, Curtis AB, Mehra MR, Albert NM, Gheorghiade M, Heywood JT, Liu Y, O'Connor CM, Reynolds D, Walsh MN, Yancy CW, Fonarow GC. Factors associated with improvement in utilization of cardiac resynchronization therapy in eligible heart failure patients: findings from IMPROVE HF. Pacing Clin Electrophysiol. 2013 Apr;36(4):433-43. doi: 10.1111/pace.12090. Epub 2013 Feb 4.
PMID: 23380000DERIVEDBarkoudah E, Skali H, Uno H, Solomon SD, Pfeffer MA. Mortality rates in trials of subjects with type 2 diabetes. J Am Heart Assoc. 2012 Feb;1(1):8-15. doi: 10.1161/JAHA.111.000059. Epub 2012 Feb 20.
PMID: 23130114DERIVEDReynolds D, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Mcbride ML, Inge PJ, Mehra MR, O'Connor CM, Walsh MN, Yancy CW, Fonarow GC. Race and improvements in the use of guideline-recommended therapies for patients with heart failure: findings from IMPROVE HF. J Natl Med Assoc. 2012 May-Jun;104(5-6):287-98. doi: 10.1016/s0027-9684(15)30156-5.
PMID: 22973678DERIVEDFonarow GC, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Liu Y, Mehra MR, O'Connor CM, Reynolds D, Walsh MN, Yancy CW. Associations between outpatient heart failure process-of-care measures and mortality. Circulation. 2011 Apr 19;123(15):1601-10. doi: 10.1161/CIRCULATIONAHA.110.989632. Epub 2011 Apr 4.
PMID: 21464053DERIVEDWalsh MN, Yancy CW, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Inge PJ, McBride ML, Mehra MR, O'Connor CM, Reynolds D, Fonarow GC. Equitable improvement for women and men in the use of guideline-recommended therapies for heart failure: findings from IMPROVE HF. J Card Fail. 2010 Dec;16(12):940-9. doi: 10.1016/j.cardfail.2010.07.250.
PMID: 21111983DERIVEDFonarow GC, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Inge PJ, Mehra MR, O'Connor CM, Reynolds D, Walsh MN, Yancy CW. Improving evidence-based care for heart failure in outpatient cardiology practices: primary results of the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). Circulation. 2010 Aug 10;122(6):585-96. doi: 10.1161/CIRCULATIONAHA.109.934471. Epub 2010 Jul 26.
PMID: 20660805DERIVEDHeywood JT, Fonarow GC, Yancy CW, Albert NM, Curtis AB, Gheorghiade M, Inge PJ, McBride ML, Mehra MR, O'Connor CM, Reynolds D, Walsh MN. Comparison of medical therapy dosing in outpatients cared for in cardiology practices with heart failure and reduced ejection fraction with and without device therapy: report from IMPROVE HF. Circ Heart Fail. 2010 Sep;3(5):596-605. doi: 10.1161/CIRCHEARTFAILURE.109.912683. Epub 2010 Jul 15.
PMID: 20634483DERIVEDWalsh MN, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, O'Connor CM, Reynolds D, Fonarow GC. Electronic health records and quality of care for heart failure. Am Heart J. 2010 Apr;159(4):635-642.e1. doi: 10.1016/j.ahj.2010.01.006.
PMID: 20362723DERIVEDMehra MR, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, O'Connor CM, Reynolds D, Walsh MN, Fonarow GC. Evidence of clinical practice heterogeneity in the use of implantable cardioverter-defibrillators in heart failure and post-myocardial infarction left ventricular dysfunction: Findings from IMPROVE HF. Heart Rhythm. 2009 Dec;6(12):1727-34. doi: 10.1016/j.hrthm.2009.08.022. Epub 2009 Aug 22.
PMID: 19959119DERIVEDCurtis AB, Yancy CW, Albert NM, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, Oconnor CM, Reynolds D, Walsh MN, Fonarow GC. Cardiac resynchronization therapy utilization for heart failure: findings from IMPROVE HF. Am Heart J. 2009 Dec;158(6):956-64. doi: 10.1016/j.ahj.2009.10.011.
PMID: 19958862DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Results Point of Contact
- Title
- IMPROVE HF, Clinical Research Specialist
- Organization
- Medtronic Cardiac Rhythm Disease Management
Study Officials
- STUDY CHAIR
Gregg Fonarow, MD
University of California at Los Angeles
- STUDY CHAIR
Clyde Yancy, MD
UT Southwestern Medical Center at Dallas
Publication Agreements
- PI is Sponsor Employee
- No
- Restriction Type
- OTHER
- Restrictive Agreement
- Yes
Study Design
- Study Type
- observational
- Observational Model
- COHORT
- Time Perspective
- PROSPECTIVE
- Sponsor Type
- INDUSTRY
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
March 15, 2006
First Posted
March 17, 2006
Study Start
May 1, 2005
Primary Completion
August 1, 2009
Study Completion
August 1, 2009
Last Updated
January 31, 2019
Results First Posted
December 27, 2012
Record last verified: 2019-01