The Impact of a Gamified Engagement Toolkit on Heart Failure Registry Participation: Results of the Engage-HF Study

To evaluate the impact of a gamified engagement toolkit on registration rates and data completeness in a real-world registry.

Engage-HF is a prospective, observational pre-test:post-test exploratory concept study involving 31 hospitals participating in the Netherlands Heart Registration Heart Failure registry (NHR-HF): 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 program 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 3- and 6-month post-test. 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-guidelines 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 3-month (4.4 vs. 2.9 patients/hospital/month, p=0.45) post-test. However, at 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-guidelines knowledge.

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.