{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:28:23Z","timestamp":1777976903439,"version":"3.51.4"},"reference-count":62,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T00:00:00Z","timestamp":1679875200000},"content-version":"unspecified","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Western Australia Health Translation Network","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,2,6]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>General practitioners (GPs) routinely provide care for patients with heart failure (HF); however, adherence to management guidelines, including titrating medication to optimal dose, can be challenging in this setting. This study will evaluate the effectiveness of a multifaceted intervention to support adherence to HF management guidelines in primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will undertake a multicentre, parallel-group, randomised controlled trial of 200 participants with HF with reduced ejection fraction. Participants will be recruited during a hospital admission due to HF. Following hospital discharge, the intervention group will have follow-up with their GP scheduled at 1\u2009week, 4 weeks and 3 months with the provision of a medication titration plan approved by a specialist HF cardiologist. The control group will receive usual care. The primary endpoint, assessed at 6 months, will be the difference between groups in the proportion of participants being prescribed five guideline-recommended treatments; (1) ACE inhibitor\/angiotensin receptor blocker\/angiotensin receptor neprilysin inhibitor at least 50% of target dose, (2) beta-blocker at least 50% of target dose, (3) mineralocorticoid receptor antagonist at any dose, (4) anticoagulation for patients diagnosed with atrial fibrillation, (5) referral to cardiac rehabilitation. Secondary outcomes will include functional capacity (6-minute walk test); quality of life (Kansas City Cardiomyopathy Questionnaire); depressive symptoms (Patient Health Questionnaire-2); self-care behaviour (Self-Care of Heart Failure Index). Resource utilisation will also be assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval was granted by the South Metropolitan Health Service Ethics Committee (RGS3531), with reciprocal approval at Curtin University (HRE2020-0322). Results will be disseminated via peer-reviewed publications and conferences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ACTRN12620001069943.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-063656","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T11:35:41Z","timestamp":1679916941000},"page":"e063656","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["<i>P<\/i>\n                    rimary care\n                    <i>A<\/i>\n                    dherence\n                    <i>T<\/i>\n                    o\n                    <i>H<\/i>\n                    eart\n                    <i>F<\/i>\n                    ailure guidelines\n                    <i>IN D<\/i>\n                    iagnosis,\n                    <i>E<\/i>\n                    valuation and\n                    <i>R<\/i>\n                    outine management (PATHFINDER): a randomised controlled trial protocol"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7843-6344","authenticated-orcid":false,"given":"Liying","family":"Dai","sequence":"first","affiliation":[{"name":"Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tashi","family":"Dorje","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mount Hospital, Perth, Western Australia, Australia"},{"name":"Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia"},{"name":"Department of Cardiology, Joondalup Health Campus, Joondalup, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Gootjes","sequence":"additional","affiliation":[{"name":"WA Cardiology, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence","family":"Dembo","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie","family":"Rankin","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Murdoch, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2417-4673","authenticated-orcid":false,"given":"Graham","family":"Hillis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Perth Hospital, Perth, Western Australia, Australia"},{"name":"Medical School, The University of Western Australia, Perth, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5703-6475","authenticated-orcid":false,"given":"Suzanne","family":"Robinson","sequence":"additional","affiliation":[{"name":"Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia"},{"name":"Deakin Health Economics, Deakin University, Melbourne, Western Australia, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2271-578X","authenticated-orcid":false,"given":"John 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