{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T21:22:43Z","timestamp":1794604963948,"version":"4.9.1"},"reference-count":49,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T00:00:00Z","timestamp":1793491200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["American Heart Journal Plus: Cardiology Research and Practice"],"published-print":{"date-parts":[[2026,11]]},"DOI":"10.1016\/j.ahjo.2026.100934","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:03:38Z","timestamp":1791270218000},"page":"100934","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["The impact of an adaptive patient-centered web application on medication optimization in patients with HFrEF: Rationale and design of the SmartHF trial"],"prefix":"10.1016","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2910-1879","authenticated-orcid":false,"given":"Michael P.","family":"Dorsch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Krambrink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabah","family":"Ganai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaitlyn M.","family":"Greer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed S.","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Stevens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzochi","family":"Nwoko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Modele O.","family":"Ogunniyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Ewald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled","family":"Abdul-Nour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Hummel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd M.","family":"Koelling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"8","key":"10.1016\/j.ahjo.2026.100934_bb0005","doi-asserted-by":"crossref","first-page":"e254","DOI":"10.1161\/CIR.0000000000000950","article-title":"Heart disease and stroke statistics-2021 update: a report from the American Heart Association","volume":"143","author":"Virani","year":"2021","journal-title":"Circulation"},{"issue":"3","key":"10.1016\/j.ahjo.2026.100934_bb0010","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1001\/jama.2017.8444","article-title":"Association of changing hospital readmission rates with mortality rates after hospital discharge","volume":"318","author":"Dharmarajan","year":"2017","journal-title":"JAMA"},{"issue":"2","key":"10.1016\/j.ahjo.2026.100934_bb0015","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.amjmed.2008.08.026","article-title":"\u201cDose-dependent\u201d impact of recurrent cardiac events on mortality in patients with heart failure","volume":"122","author":"Lee","year":"2009","journal-title":"Am. J. Med."},{"issue":"11","key":"10.1016\/j.ahjo.2026.100934_bb0020","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1001\/archinte.165.11.1274","article-title":"Health-related quality of life as a predictor of hospital readmission and death among patients with heart failure","volume":"165","author":"Rodr\u00edguez-Artalejo","year":"2005","journal-title":"Arch. Intern. Med."},{"issue":"12","key":"10.1016\/j.ahjo.2026.100934_bb0025","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1093\/gerona\/glr171","article-title":"Risk of continued institutionalization after hospitalization in older adults","volume":"66","author":"Goodwin","year":"2011","journal-title":"J. Gerontol. A Biol. Sci. Med. Sci."},{"issue":"2","key":"10.1016\/j.ahjo.2026.100934_bb0030","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.cardfail.2014.12.002","article-title":"Heart failure is a major contributor to hospital readmission penalties","volume":"21","author":"Vidic","year":"2015","journal-title":"J. Card. Fail."},{"issue":"3","key":"10.1016\/j.ahjo.2026.100934_bb0035","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/S1071-9164(97)90013-0","article-title":"Safety and efficacy of carvedilol in severe heart failure. The U.S. Carvedilol Heart Failure Study Group","volume":"3","author":"Cohn","year":"1997","journal-title":"J. Card. Fail."},{"issue":"22","key":"10.1016\/j.ahjo.2026.100934_bb0040","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1056\/NEJM200105313442201","article-title":"Effect of carvedilol on survival in severe chronic heart failure","volume":"344","author":"Packer","year":"2001","journal-title":"N. Engl. J. Med."},{"issue":"9146","key":"10.1016\/j.ahjo.2026.100934_bb0045","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S0140-6736(98)11181-9","article-title":"The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial","volume":"353","year":"1999","journal-title":"Lancet"},{"issue":"5","key":"10.1016\/j.ahjo.2026.100934_bb0050","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1056\/NEJM199108013250501","article-title":"Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure","volume":"325","author":"SOLVD Investigators","year":"1991","journal-title":"N. Engl. J. Med."},{"issue":"23","key":"10.1016\/j.ahjo.2026.100934_bb0055","doi-asserted-by":"crossref","first-page":"2312","DOI":"10.1161\/01.CIR.100.23.2312","article-title":"Comparative effects of low and high doses of the angiotensin-converting enzyme inhibitor, lisinopril, on morbidity and mortality in chronic heart failure. ATLAS Study Group","volume":"100","author":"Packer","year":"1999","journal-title":"Circulation"},{"issue":"9386","key":"10.1016\/j.ahjo.2026.100934_bb0060","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/S0140-6736(03)14284-5","article-title":"Effects of candesartan in patients with chronic heart failure and reduced left-ventricular systolic function intolerant to angiotensin-converting-enzyme inhibitors: the CHARM-Alternative trial","volume":"362","author":"Granger","year":"2003","journal-title":"Lancet"},{"issue":"3","key":"10.1016\/j.ahjo.2026.100934_bb0065","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.jacc.2016.04.047","article-title":"Influence of sacubitril\/valsartan (LCZ696) on 30-day readmission after heart failure hospitalization","volume":"68","author":"Desai","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"issue":"10","key":"10.1016\/j.ahjo.2026.100934_bb0070","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1056\/NEJM199909023411001","article-title":"The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators","volume":"341","author":"Pitt","year":"1999","journal-title":"N. Engl. J. Med."},{"issue":"1","key":"10.1016\/j.ahjo.2026.100934_bb0075","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1056\/NEJMoa1009492","article-title":"Eplerenone in patients with systolic heart failure and mild symptoms","volume":"364","author":"Zannad","year":"2011","journal-title":"N. Engl. J. Med."},{"issue":"21","key":"10.1016\/j.ahjo.2026.100934_bb0080","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1056\/NEJMoa1911303","article-title":"Dapagliflozin in patients with heart failure and reduced ejection fraction","volume":"381","author":"McMurray","year":"2019","journal-title":"N. Engl. J. Med."},{"issue":"15","key":"10.1016\/j.ahjo.2026.100934_bb0085","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1056\/NEJMoa2022190","article-title":"EMPEROR-Reduced Trial Investigators. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure","volume":"383","author":"Packer","year":"2020","journal-title":"N. Engl. J. Med."},{"issue":"2","key":"10.1016\/j.ahjo.2026.100934_bb0090","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.amjcard.2009.08.681","article-title":"Adherence to guideline-recommended adjunctive heart failure therapies among outpatient cardiology practices (findings from IMPROVE HF)","volume":"105","author":"Yancy","year":"2010","journal-title":"Am. J. Cardiol."},{"issue":"24","key":"10.1016\/j.ahjo.2026.100934_bb0095","doi-asserted-by":"crossref","first-page":"2706","DOI":"10.1093\/eurheartj\/ehi499","article-title":"Under-utilization of evidence-based drug treatment in patients with heart failure is only partially explained by dissimilarity to patients enrolled in landmark trials: a report from the Euro Heart Survey on Heart Failure","volume":"26","author":"Lenzen","year":"2005","journal-title":"Eur. Heart J."},{"issue":"4","key":"10.1016\/j.ahjo.2026.100934_bb0100","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.jacc.2018.04.070","article-title":"Medical therapy for heart failure with reduced ejection fraction: the CHAMP-HF registry","volume":"72","author":"Greene","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"issue":"2","key":"10.1016\/j.ahjo.2026.100934_bb0105","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1001\/jamacardio.2021.4585","article-title":"Evaluation of quality of care for US veterans with recent-onset heart failure with reduced ejection fraction","volume":"7","author":"Sandhu","year":"2022","journal-title":"JAMA Cardiol."},{"issue":"2","key":"10.1016\/j.ahjo.2026.100934_bb0110","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.030952","article-title":"Challenge of optimizing medical therapy in heart failure: unlocking the potential of digital health and patient engagement","volume":"13","author":"Azizi","year":"2024","journal-title":"J. Am. Heart Assoc."},{"issue":"7494","key":"10.1016\/j.ahjo.2026.100934_bb0115","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1136\/bmj.38398.500764.8F","article-title":"Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success","volume":"330","author":"Kawamoto","year":"2005","journal-title":"BMJ"},{"issue":"1","key":"10.1016\/j.ahjo.2026.100934_bb0120","doi-asserted-by":"crossref","first-page":"29","DOI":"10.7326\/0003-4819-157-1-201207030-00450","article-title":"Effect of clinical decision-support systems: a systematic review","volume":"157","author":"Bright","year":"2012","journal-title":"Ann. Intern. Med."},{"key":"10.1016\/j.ahjo.2026.100934_bb0125","first-page":"1","article-title":"Enabling health care decisionmaking through clinical decision support and knowledge management","volume":"203","author":"Lobach","year":"2012","journal-title":"Evid Rep Technol Assess (Full Rep)."},{"issue":"2","key":"10.1016\/j.ahjo.2026.100934_bb0130","doi-asserted-by":"crossref","DOI":"10.2196\/medinform.4553","article-title":"Putting meaning into meaningful use: a roadmap to successful integration of evidence at the point of care","volume":"4","author":"McGinn","year":"2016","journal-title":"JMIR Med. Inform."},{"issue":"10","key":"10.1016\/j.ahjo.2026.100934_bb0135","doi-asserted-by":"crossref","first-page":"742","DOI":"10.7326\/0003-4819-144-10-200605160-00125","article-title":"Systematic review: impact of health information technology on quality, efficiency, and costs of medical care","volume":"144","author":"Chaudhry","year":"2006","journal-title":"Ann. Intern. Med."},{"issue":"2","key":"10.1016\/j.ahjo.2026.100934_bb0140","first-page":"79","article-title":"The use and effectiveness of electronic clinical decision support tools in the ambulatory\/primary care setting: a systematic review of the literature","volume":"16","author":"Bryan","year":"2008","journal-title":"Inform. Prim. Care"},{"issue":"10","key":"10.1016\/j.ahjo.2026.100934_bb0145","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1001\/jama.293.10.1223","article-title":"Effects of computerized clinical decision support systems on practitioner performance and patient outcomes","volume":"293","author":"Garg","year":"2005","journal-title":"JAMA"},{"issue":"15","key":"10.1016\/j.ahjo.2026.100934_bb0150","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1001\/jama.280.15.1339","article-title":"Effects of computer-based clinical decision support systems on physician performance and patient outcomes","volume":"280","author":"Hunt","year":"1998","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.ahjo.2026.100934_bb0155","doi-asserted-by":"crossref","first-page":"12","DOI":"10.5334\/egems.259","article-title":"The imperative for patient-centered clinical decision support","volume":"6","author":"Marcial","year":"2018","journal-title":"eGEMs (Generating Evidence & Methods to improve patient outcomes)"},{"issue":"10","key":"10.1016\/j.ahjo.2026.100934_bb0160","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0186458","article-title":"Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence","volume":"12","author":"N\u00e1fr\u00e1di","year":"2017","journal-title":"PloS One"},{"issue":"2","key":"10.1016\/j.ahjo.2026.100934_bb0165","doi-asserted-by":"crossref","first-page":"110","DOI":"10.7326\/M17-1805","article-title":"Comparative effectiveness of implementation strategies for blood pressure control in hypertensive patients: a systematic review and meta-analysis","volume":"168","author":"Mills","year":"2018","journal-title":"Ann. Intern. Med."},{"issue":"1","key":"10.1016\/j.ahjo.2026.100934_bb0170","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1145\/272991.272995","article-title":"Mersenne twister: a 623-dimensionally equidistributed uniform pseudo-random number generator","volume":"8","author":"Matsumoto","year":"1998","journal-title":"ACM Trans. Model Comput. Simul."},{"issue":"3","key":"10.1016\/j.ahjo.2026.100934_bb0175","article-title":"A computable algorithm for medication optimization in heart failure with reduced ejection fraction","volume":"2","author":"Dorsch","year":"2023","journal-title":"JACC: Advances"},{"issue":"1","key":"10.1016\/j.ahjo.2026.100934_bb0180","doi-asserted-by":"crossref","DOI":"10.1002\/phar.70101","article-title":"Association of an algorithm-generated medication optimization score with clinical outcomes in ambulatory patients with heart failure","volume":"46","author":"Ali","year":"2026","journal-title":"Pharmacotherapy"},{"issue":"1","key":"10.1016\/j.ahjo.2026.100934_bb0185","doi-asserted-by":"crossref","DOI":"10.1016\/j.jacadv.2025.102375","article-title":"The association between office, video, and telemanagement encounters and GDMT optimization in advanced HFrEF","volume":"5","author":"Ali","year":"2025","journal-title":"JACC Adv."},{"issue":"5","key":"10.1016\/j.ahjo.2026.100934_bb0190","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.jacc.2021.11.033","article-title":"Optimal background pharmacological therapy for heart failure patients in clinical trials: JACC review topic of the week","volume":"79","author":"Fiuzat","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"issue":"100438","key":"10.1016\/j.ahjo.2026.100934_bb0195","article-title":"Protocol-driven approach to guideline-directed medical therapy optimization for heart failure: a real-world application to recovery","volume":"45","author":"Yan","year":"2024","journal-title":"Am. Heart J. Plus"},{"key":"10.1016\/j.ahjo.2026.100934_bb0200","article-title":"Social determinants of health and disparities in guideline-directed medical therapy optimization for heart failure","author":"Jacobs","year":"2024","journal-title":"Circ. Heart Fail."},{"issue":"9","key":"10.1016\/j.ahjo.2026.100934_bb0205","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.122.010278","article-title":"DASH-HF study: a pragmatic quality improvement randomized implementation trial for patients with Heart Failure with reduced ejection fraction","volume":"16","author":"Verma","year":"2023","journal-title":"Circ. Heart Fail."},{"issue":"3","key":"10.1016\/j.ahjo.2026.100934_bb0210","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1002\/ehf2.14705","article-title":"Guideline-directed medical therapy assessment in heart failure patients undergoing percutaneous mitral valve repair","volume":"11","author":"Kresoja","year":"2024","journal-title":"ESC Heart Fail."},{"issue":"5","key":"10.1016\/j.ahjo.2026.100934_bb0215","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCHEARTFAILURE.123.011164","article-title":"Generalizable approach to quantifying guideline-directed medical therapy","volume":"17","author":"Khan","year":"2024","journal-title":"Circ. Heart Fail."},{"issue":"4","key":"10.1016\/j.ahjo.2026.100934_bb0220","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.jacc.2025.12.066","article-title":"AI-guided GDMT optimization after HFrEF hospitalization: the ASSIST-HF SIRIO randomized pilot trial","volume":"88","author":"Navarese","year":"2026","journal-title":"J. Am. Coll. Cardiol."},{"issue":"5","key":"10.1016\/j.ahjo.2026.100934_bb0225","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1161\/CIRCULATIONAHA.120.051863","article-title":"An electronically delivered patient-activation tool for intensification of medications for chronic heart failure with reduced ejection fraction: the EPIC-HF trial","volume":"143","author":"Allen","year":"2021","journal-title":"Circulation"},{"issue":"6","key":"10.1016\/j.ahjo.2026.100934_bb0230","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pdig.0000868","article-title":"Pharmacist-led rapid uptitration clinic in heart failure patients with reduced ejection fraction: our experience within a virtual ward","volume":"4","author":"Alhakem","year":"2025","journal-title":"PLOS Digit Health."},{"issue":"3","key":"10.1016\/j.ahjo.2026.100934_bb0235","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/JCN.0000000000001051","article-title":"Use of human-centered design methodology to develop a digital toolkit to optimize heart failure guideline-directed medical therapy","volume":"39","author":"Spaulding","year":"2024","journal-title":"J. Cardiovasc. Nurs."},{"issue":"14","key":"10.1016\/j.ahjo.2026.100934_bb0240","article-title":"Patient perspectives on digital interventions to manage heart failure medications: the VITAL-HF pilot","volume":"12","author":"Samsky","year":"2023","journal-title":"J. Clin. Med. Res."},{"key":"10.1016\/j.ahjo.2026.100934_bb0245","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(22)02076-1","article-title":"Safety, tolerability and efficacy of up-titration of guideline-directed medical therapies for acute heart failure (STRONG-HF): a multinational, open-label, randomised, trial","author":"Mebazaa","year":"2022","journal-title":"Lancet"}],"container-title":["American Heart Journal Plus: Cardiology Research and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666602226002235?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2666602226002235?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T21:00:00Z","timestamp":1794603600000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2666602226002235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,11]]},"references-count":49,"alternative-id":["S2666602226002235"],"URL":"https:\/\/doi.org\/10.1016\/j.ahjo.2026.100934","relation":{},"ISSN":["2666-6022"],"issn-type":[{"value":"2666-6022","type":"print"}],"subject":[],"published":{"date-parts":[[2026,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"The impact of an adaptive patient-centered web application on medication optimization in patients with HFrEF: Rationale and design of the SmartHF trial","name":"articletitle","label":"Article Title"},{"value":"American Heart Journal Plus: Cardiology Research and Practice","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ahjo.2026.100934","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"100934"}}