Digital Outreach for Heart Failure Adherence

The goal of the ADHERE-HF study is to evaluate whether care-embedded, operationally delivered digital outreach improves medication refill, adherence, and clinical outcomes among adults with heart failure who are overdue for a refill of an eligible guideline-directed medical therapy (GDMT) medication. The main question it aims to answer is: Does digital outreach using interactive text messages or automated telephone calls increase short-term refill of overdue heart failure medications compared with usual care? The study will evaluate the effectiveness of a digital outreach strategy delivered through existing health system communication channels. Members who have opted in to pharmacy text messaging will receive interactive text messages, while those who have not opted in will receive an interactive automated telephone call. The comparison group will receive usual care with no additional outreach.

Inclusion Criteria: 1. Age ≥18 years 2. Active KPNC membership 3. Heart failure diagnosis documented at least 6 months before the index date, with a documented EF 4. Prescribed at least one eligible GDMT medication for ≥6 months: 1. HFpEF (EF≥50%): ARNI (sacubitril/valsartan); MRA; SGLT2i 2. HFrEF or HFmrEF (EF \