Project A

• To use and prove value of the infrastructure by an observational, longitudinal research on the entire spectrum of patients with heart failure (including patients with HFpEF) in the Netherlands with focus on guideline recommended diagnostic trajectories and treatment.

The analysis in this project will focus on three main topics: patient subgroups, prognosis and quality of care. Patient subgroups will focus on HFpEF, including current treatment and phenotype clustering to reshape and refine disease entities. Also included here are sex related differences in HF and elderly, specifically differences related to suboptimal treatment and comorbidities.

Prognosis will be investigated in relation to NYHA class, ejection fraction and will consist of both mortality and morbidity outcomes: all-cause mortality, (non) cardiovascular mortality and hospitalisation and HF hospitalisation. Uptake of new recommended drugs will also be studied, including health technology assessment of current and new treatments. Quality of care is related to GDMT adherence, the challenges in achieving target dose and the relation between target dose and outcome measures.

Synergy with other work packages and initiatives

Before starting observational data analysis, certain prerequisites must be fulfilled for the HF registration. One of the aims of this project is to motivate the HF teams, balancing the workload/use of resources and minimal requirement of technical expertise with the ENGAGE-HF study.

Project A will make sure there is synergy with other registration studies, including TITRATE-HF and SELEQT-HF. In addition, it will streamline with other work packages to improve data extraction and upload processes and establishing links to other data sources, such as cause of death. Project A is looking for synergy with national and regional collaborative opportunities, including Health-RI, to support electronic health record-based registration.

ENGAGE-HF

Part of project A is the development of an engagement tool to promote the ease of registration and stimulate intrinsic motivation of caregivers with a competitive element to promote data entry (inclusion numbers) and data completeness (data quality). This tool is aimed at heart failure nurses and deploys "gamification" and "engagement" in learning to make optimal use of quality registrations and treatment guideline implementation.