biostudies-literatureDickert NWAHRQ HHSe011273https://www.ebi.ac.uk/biostudies/studies/S-EPMC11745761biostudies-literatureUnknown18(1)<h4>Background</h4>Guideline-directed medical therapy for heart failure (HF) with reduced ejection fraction can entail high out-of-pocket (OOP) costs, prompting concerns about financial toxicity and access. OOP costs are generally unavailable during encounters. This trial assessed the impact of providing patient-specific OOP costs to patients and clinicians.<h4>Methods</h4>This trial was conducted between June 2021 and August 2023 at 6 clinics in 2 health systems using a stepped-wedge, clinic-level cluster-randomized design. Adult patients with HF with reduced ejection fraction (left ventricular ejection fraction ≤40%) were enrolled. The intervention was built upon the EPIC-HF (Electronically Delivered, Patient-Activation Tool for Intensification of Medications for Chronic Heart Failure wiCirculation. Cardiovascular quality and outcomesIntegrating Out-of-Pocket Costs Into Shared Decision-Making for Heart Failure With Reduced Ejection Fraction: A Stepped-Wedge Trial (POCKET-COST-HF).PMC11745761R01 HS026081Scherer LDRao BRMatlock DDSloan CEHalpern SDMitchell ARMontembeau SCNoonan KUbel PAAllen LAKo YAMorris AADickert NWSpeight CDBiermann HMoore MABalser MDavis JKKrishnan AfalseIntegrating Out-of-Pocket Costs Into Shared Decision-Making for Heart Failure With Reduced Ejection Fraction: A Stepped-Wedge Trial (POCKET-COST-HF).<h4>Background</h4>Guideline-directed medical therapy for heart failure (HF) with reduced ejection fraction can entail high out-of-pocket (OOP) costs, prompting concerns about financial toxicity and access. OOP costs are generally unavailable during encounters. This trial assessed the impact of providing patient-specific OOP costs to patients and clinicians.<h4>Methods</h4>This trial was conducted between June 2021 and August 2023 at 6 clinics in 2 health systems using a stepped-wedge, clinic-level cluster-randomized design. Adult patients with HF with reduced ejection fraction (left ventricular ejection fraction ≤40%) were enrolled. The intervention was built upon the EPIC-HF (Electronically Delivered, Patient-Activation Tool for Intensification of Medications for Chronic Heart Failure wi2025-01-01T00:00:00Z2025 Jan2026-07-15T11:05:19.29Z2025-04-05T09:32:41.713ZS-EPMC117457613962489210.1161/circoutcomes.124.01127310.1161/CIRCOUTCOMES.124.011273