The impact of a gamified engagement toolkit on heart failure registry participation: results of the Engage-HF study

AIMS: This study aims to evaluate the impact of a gamified engagement toolkit on registration rates and data completeness in a real-world registry. METHODS AND RESULTS: Engage-HF is a prospective, observational pre-test-post-test exploratory concept study involving 31 hospitals participating in the Netherlands Heart Registration-Heart Failure (NHR-HF) registry: 12 that were technically ready and willing to participate formed the intervention group, while the remaining 19 NHR-HF hospitals served as controls. In the intervention group, 28 HF nurse specialists participated in a 24-week educational programme using the Engage-HF toolkit. The primary endpoint was participation, measured by a performance index (average number of patients registered per hospital per month) at the end of the intervention and at the 3- and 6-month post-test. The secondary endpoint was data completeness, and an exploratory analysis evaluated participants' experiences with the toolkit and its impact on their HF registries and 2021 ESC HF guideline knowledge. The intervention group showed a numerically higher performance index at the end of the intervention (5.2 vs. 2.1 patients/hospital/month, P = 0.41) and at the 3-month post-test (4.4 vs. 2.9 patients/hospital/month, P = 0.45). However, at the 6-month post-test, the performance index was higher in the control group (3.3 vs. 4.0 patients/hospital/month, P = 0.98). Data completeness was high in both groups, with variable-specific differences without a clear pattern. Participants rated the toolkit positively as an educational toolkit but reported neutral impacts on HF registries or 2021 ESC HF guideline knowledge. CONCLUSION: The Engage-HF toolkit was well received and may boost short-term participation but did not improve long-term participation or the already high data completeness.