EMAIL-HF: Can Digital Strategies Shorten the Path from Scientific Evidence to Clinical Practice in Heart Failure?
A substantial gap persists between scientific evidence and clinical practice in heart failure (HF). Digital solutions have emerged as promising strategies to accelerate the implementation of evidence-based therapies. This mini-review examines the results of the EMAIL-HF study, a registry-based, randomized, controlled, parallel-group clinical trial conducted in Denmark that included patients aged 20 years or older with a diagnosis of HF irrespective of left ventricular ejection fraction, who were not receiving SGLT2 inhibitors (SGLT2i). Participants were randomized to usual care or a digital strategy consisting of an e-mailed letter with information on SGLT2i, followed by contact with an HF specialist. The primary endpoint was the proportion of patients redeeming a prescription for dapagliflozin or empagliflozin within 6 months of randomization and the secondary endpoint was a composite of time to first HF hospitalization or death from any cause. The digital strategy significantly increased SGLT2i initiation within 6 months, although no difference in HF hospitalization or all-cause mortality was observed during the 24-month follow-up. Whether these strategies can translate modest improvements in treatment uptake into sustained, scalable, and cost-effective gains across diverse healthcare systems remains uncertain.
Authors
- Mario Enrico Canonico (ORCID: https://orcid.org/0000-0001-8452-7464)
- Patrícia O. Guimarães (ORCID: https://orcid.org/0000-0002-0626-2250)
- Dike Bevis Ojji (ORCID: https://orcid.org/0000-0002-2084-1988)
- Kaveh Hosseini (ORCID: https://orcid.org/0000-0001-5676-3099)
- Eduardo Bello Martins (ORCID: https://orcid.org/0000-0001-8752-2175)
- Yasuhiko Sakata (ORCID: https://orcid.org/0000-0001-6809-8487)
- Mitja Lainščak (ORCID: https://orcid.org/0000-0002-5922-4098)
- Savina Nodari (ORCID: https://orcid.org/0000-0002-6650-1735)
- Luca Monzo (ORCID: https://orcid.org/0000-0003-2958-943X)
- Jan Biegus (ORCID: https://orcid.org/0000-0001-9977-7722)
- Kalliopi Keramida (ORCID: https://orcid.org/0000-0002-9533-6951)
- Tamás Alexy (ORCID: https://orcid.org/0000-0001-8381-6299)
- Francesca Musella (ORCID: https://orcid.org/0000-0002-2116-3293)
- Caio A.M. Tavares (ORCID: https://orcid.org/0000-0002-2366-3371)
- Monica T A Albuquerque (ORCID: https://orcid.org/0009-0003-5548-2510)
- VAGNER MADRINI JUNIOR
- Andrew Ambrosy
Institutions
- University of Minnesota (US)
- Kaiser Permanente (US)
- University of Ljubljana (SI)
- Inserm (FR)
- Hospital Israelita Albert Einstein (BR)
- Copenhagen University Hospital (DK)
- Gentofte Hospital (DK)
- Karolinska Institutet (SE)
- Wroclaw Medical University (PL)
- Centre Hospitalier Régional et Universitaire de Nancy (FR)
- National Cerebral and Cardiovascular Center (JP)
- St Savas Hospital (GR)
- Kaiser Permanente San Francisco Medical Center (US)
- University of Abuja Teaching Hospital (NG)
- Défaillance Cardiovasculaire Aiguë et Chronique (FR)
- Kaiser Permanente Northern California (US)
- University of Colorado Anschutz Medical Campus (US)
- University of Brescia (IT)
- Université de Lorraine (FR)
Publication Details
- Journal
- Heart Failure Reviews
- Published
- 2026-11-07
- DOI
- https://doi.org/10.1007/s10741-026-10691-7
- Primary Topic
- Heart Failure Treatment and Management
- Type
- article
- Field-Weighted Citation Impact
- 0.00