Digital Implementation Strategy to Increase SGLT2 Inhibitor Uptake in Heart Failure: Study Design of EMAIL-HF
Year: 2025
Type: article
Abstract: AIMS: The EMAIL-HF trial aims to evaluate whether a digital guideline implementation strategy can increase and accelerate initiation of sodium-glucose co-transporter 2 (SGLT2) inhibitors in patients with heart failure (HF). METHODS AND RESULTS: EMAIL-HF is a pragmatic, registry-based, randomized controlled trial including patients with a diagnosis of HF within the last 10 years, residing in the Capital Region of Denmark and the municipality of Roskilde (~2 million inhabitants). A total of 5996 eligible patients not already treated with SGLT2 inhibitors were identified from nationwide health registries and randomized 1:1 to either receive a digital letter providing information on SGLT2 inhibitors with an invitation for evaluation (intervention group: 2979 patients), or to usual care without the letter (control group: 3017 patients). The median age was 73 years (intervention) vs. 74 years (control), with 67.4% and 66.5% males, respectively. The primary outcome is the proportion of patients initiating SGLT2 inhibitor therapy within 6 months after randomization. The secondary outcome is a composite of time to first HF hospitalization or all-cause mortality. Additional exploratory outcomes include adherence, clinical events, healthcare utilization and subgroup analyses. Full baseline characteristics and clinical outcomes will be reported after completion of event accrual. CONCLUSIONS: EMAIL-HF will determine whether a population-wide digital strategy can increase and accelerate guideline-based initiation of SGLT2 inhibitors in patients with chronic HF. This trial may offer a scalable model to improve implementation of novel therapies in routine clinical practice.
Source: ESC Heart Failure
DOI: 10.1002/ehf2.15398
Authors: Mariam Elmegaard, Lars Køber, Mads Kristian Ersbøll, Theis Lange, Christian Ditlev Tuxen, Mette Rauhe Mouridsen, Trine Kiilerich Lauridsen, Jens Jakob Thune, Peter Godsk Jørgensen, Morten Lamberts, Nadia Paarup Dridi, Peter Bonfils, Morten Petersen, Nis Ottesen Stride, Anders Barasa, Jesper Jensen, Caroline Garred, Emil Fosbøl, Emil Wolsk, John McMurray, Mark Petrie, Morten Schou
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $4,850
Funders: Boehringer Ingelheim, Novo Nordisk Fonden
OpenAlex ID: W4413510164