Margaret Harvey, PhD, APRN, ACNP-BC, CHFN
Analytical, Diagnostic and Therapeutic Techniques and Equipment | Cardiology | Cardiovascular Diseases | Diseases | Health and Medical Administration | Investigative Techniques | Medical Specialties | Medicine and Health Sciences | Nursing | Nursing Administration | Therapeutics
Purpose/Background Heart failure (HF) is a leading cause of hospital readmissions and lost revenue under the Hospital Readmission Reduction Program (HRRP). Medication management plays a crucial role in controlling HF symptoms leading to hospitalization. This scoping review examines the benefits of angiotensin receptor-neprilysin inhibitors versus beta-blockers in reducing hospital readmissions within 30 days of discharge related to heart failure with reduced ejection fraction (HFrEF) in the United States.
Methods We conducted a literature search from August 2020 to November 2021 on the Google Scholar, PubMed, and CINAHL databases using the key phrases heart failure with reduced ejection, beta-blockers, angiotensin receptor-neprilysin inhibitor, and hospital readmission. Inclusion criteria include peer review, English language, publication within the past five years, free access, and full-text availability. Ultimately, we chose ten articles based on relevance, rigor, and quality.
Results Our review shows that both BBs and ARNIs aid in reducing hospital readmissions as well as mortality in patients with HFrEF. However, ARNIs are typically used later in the progression of HF and are generally part of combination therapy. We were unable to find a single study that directly compared the efficacy of BBs to ARNIs as monotherapies in reducing 30-day hospital readmissions.
Implications for Nursing Practice This scoping review provides insight into the complexity of medication management for HFrEF and its role in reducing hospitalizations. Our review indicates a need for further research into the implementation of ARNIs as monotherapy in the treatment of HF compared to BBs.
Bebout, Jesse MSN, RN, CCRN; May, Brandon BSN, RN; Richmond, Tiara BSN, RN; and Harvey, Margaret PhD, APRN, ACNP-BC, CHFN , "Reducing 30 Day CHF Readmission Rates: Evaluating Medication Efficacy" (2022). Doctor of Nursing Practice Projects. Paper 24. http://dx.doi.org/10.21007/con.dnp.2022.0024.