چکیده (انگلیسی):

Background:Heart failure (HF) is mainly detected and managed in primary care, but the care is considered
suboptimal. We present the rationale, design and baseline results of the Treatment Optimisation in Primary care
of Heart failure in the Utrecht region (TOPHU) study. In this study we assess the effect of a single training of GPs in
the pharmacological management of patients with HF.
Methods/design:A cluster randomised controlled trial. Thirty primary care practices are randomly assigned to care
as usual or intervention defined as a single training in the up-titration and management of HF drug therapy
according to the heart failure guidelines of the European Society of Cardiology (ESC). Patients with a GP’s diagnosis
of HF will be re-evaluated by an expert panel of two cardiologists and a GP with expertise in HF to come to a
definite diagnosis of HF according to the ESC heart failure guidelines. Those with definite HF will be analysed in this
study. Drug use will be measured after six months, health status after twelve months, and heart-related hospital
admissions and all-cause mortality after two years.
Discussion:Our cluster randomised trial will show whether a single training of GPs improves the pharmacological
management of patients with HF and confers beneficial effects on health status after one year, and cardiac hospital
admissions and all-cause mortality after two years of follow-up.
Trial registration:ClinicalTrials.gov Identifier NCT01662323