{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:20:22Z","timestamp":1792200022336,"version":"4.4.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":1075,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T00:00:00Z","timestamp":1670025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Department of Cardiovascular Diseases, UZ Leuven"},{"name":"Department of Public Health and Primary Care"},{"name":"Department of Cardiovascular Diseases, ZOL Genk"},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","award":["S54755"],"award-info":[{"award-number":["S54755"]}],"id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","award":["S54755"],"award-info":[{"award-number":["S54755"]}],"id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Heart failure (HF) is an important health problem for which multidisciplinary care is recommended, yet few studies involve primary care practitioners in the multidisciplinary management of HF. We set up a multifaceted prospective observational trial, OSCAR-HF, piloting audit and feedback, natriuretic peptide testing at the point of care, and the assistance of a specialist HF nurse in primary care. The aim was to optimize HF care in general practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>This is an analysis at 6 month follow-up of the study interventions of the OSCAR-HF pilot study, a nonrandomized, noncontrolled prospective observational trial conducted in eight Belgian general practices [51 general practitioners (GPs)]. Patients who were assessed by their GP to have HF constituted the OSCAR-HF study population. We used descriptive statistics and mixed-effects modelling for the quantitative analysis and thematic analysis of the focus group interviews. There was a 10.2% increase in the registered HF population after 6 months of follow-up (n = 593) compared with baseline (n = 538) and a 27% increase in objectified HF diagnoses (baseline n = 359 to 456 at T6 M). Natriuretic peptide testing (with or without referral) accounted for 54% (n = 60\/111) of the newly registered HF diagnoses. There was no difference in the proportion of patients with HF with reduced ejection fraction who received their target dosage of renin-angiotensin-aldosterone system inhibitors or beta-blockers at 6 months compared with baseline (P = 0.9). Patients who received an HF nurse intervention (n = 53) had significantly worse quality of life at baseline [difference in Minnesota Living with Heart Failure Questionnaire (MLHFQ) score 9.2 points; 95% confidence interval (CI) 4.0, 14] and had a significantly greater improvement in quality-of-life scores at the 6 month follow-up [change in MLHFQ score \u22129.8 points; 95% CI \u221215, \u22124.5] than patients without an HF nurse intervention. GPs found audit and feedback valuable but time intensive. Natriuretic peptides were useful, but the point-of-care test was impractical, and the assistance of an HF nurse was a useful addition to routine HF care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of audit and feedback combined with natriuretic peptide testing was a successful strategy to increase the number of registered and objectified HF diagnoses at 6 months. GPs and HF nurses selected patients with worse quality-of-life scores at baseline for the HF nurse intervention, which led to a significantly greater improvement in quality-of-life scores at the 6 month follow-up compared with patients without an HF nurse intervention. The interventions were deemed feasible and useful by the participating GPs with some specific remarks that can be used for optimization.<\/jats:p>\n                    <jats:p>Trial Registration: ClinicalTrials.gov (NCT02905786), registered on 14 September 2016 at https:\/\/clinicaltrials.gov\/.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.14251","type":"journal-article","created":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T03:33:55Z","timestamp":1670038435000},"page":"907-916","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Mixed-Methods Evaluation of a Multifaceted Heart Failure Intervention in General Practice: The OSCAR-HF Pilot Study"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7725-4429","authenticated-orcid":false,"given":"Miek","family":"Smeets","sequence":"first","affiliation":[{"name":"Department of Public Health and Primary Care, KU Leuven , Kapucijnenvoer 7, blok D bus 7001, 3000, Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem","family":"Raat","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, KU Leuven , Kapucijnenvoer 7, blok D bus 7001, 3000, Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert","family":"Aertgeerts","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, KU Leuven , Kapucijnenvoer 7, blok D bus 7001, 3000, Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joris","family":"Penders","sequence":"additional","affiliation":[{"name":"Department of Clinical Biology, Ziekenhuis Oost-Limburg (ZOL) , Genk ,","place":["Belgium"]},{"name":"Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University , Diepenbeek ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Vercammen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg (ZOL) , Genk ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Droogne","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospitals Leuven, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilfried","family":"Mullens","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University , Diepenbeek ,","place":["Belgium"]},{"name":"Department of Cardiology, Ziekenhuis Oost-Limburg (ZOL) , Genk ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Janssens","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases, University Hospitals Leuven, KU Leuven , Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bert","family":"Vaes","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, KU Leuven , Kapucijnenvoer 7, blok D bus 7001, 3000, Leuven ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,3]]},"reference":[{"key":"2026012114110721900_ehf214251-bib-0001","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1038\/nrcardio.2016.25","article-title":"Epidemiology and aetiology of heart failure","volume":"13","author":"Ziaeian","year":"2016","journal-title":"Nat Rev 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