Implementation of an Encounter-based Patient Decision Aid for Heart Failure Medications in Heart Function Clinics: the SHARE-HF Pragmatic, Stepped-wedge Trial

The goal of this clinical trial is to learn if a shared decision-making tool called SHARE-HF can help more people with heart failure receive guideline-recommended medications. The study includes adults with a type of heart failure called heart failure with reduced ejection fraction (HFrEF), who attend heart function clinics in British Columbia, Canada. The main question it aims to answer is: \- Does use of SHARE-HF during clinic visits lead to more participants receiving their recommended heart failure medications after 6 months? Researchers will compare clinics using the SHARE-HF tool to clinics providing usual care to see if the tool helps more participants get their recommended medications. Participants will use the SHARE-HF web-based tool with their clinician during regular clinic visits. The tool shows participants how their heart failure may affect their health over time, explains their medication options, and helps them and their clinician make treatment decisions together.

Inclusion Criteria: 1. Patient in a participating HF clinic; 2. In-person initial HF clinic visit; 3. Age 40-85 years; 4. Heart failure with reduced ejection fraction (HFrEF), as indicated by latest cardiac imaging demonstrating ejection fraction ≤40%. Exclusion Criteria: 1. Previous request to the clinic not to be contacted for research; 2. Consent opt-out; 3. Non-BC residents; 4. Residents of long-term care facilities or hospice; 5. Receiving palliative care; 6. End-stage kidney disease on dialysis or latest estimated glomerular filtration rate (eGFR) \