Impact of Guideline Directed Medical Therapy on Readmission in Heart Failure Patients >65 Years

Tara Carney

Co-Presenters: Individual Presentation

College: College of Health Professions and Human Services

Major: MSN.NURSINGLDSHP

Faculty Research Mentor: Rivera, Elsie  

Abstract:

Impact of Early Initiation of Guideline Directed Medical Therapy on 60- Day Readmissions in Hospitalized Heart Failure Patients Aged ≥65 YearsTara Carney BSN, RN, Department of Nursing, Kean UniversityObjectives: Approximately 6.7 million Americans over 20 years of age have Heart Failure, and the prevalence is expected to rise to 8.7 million Americans in 2030, 10.3 million in 2040, and 11.4million Americans by 2050. Heart failure with reduced ejection fraction (HFrEF) remains a leading cause of morbidity, mortality, and hospital readmissions among adults 65 and older in the United States. Despite strong evidence supporting guideline-directed medical therapy (GDMT) which consists of angiotensin receptor–neprilysin inhibitors (ARNi’s), heart failure specific beta-blockers, mineralocorticoid receptor antagonists (MRA), and sodium–glucose cotransporter-2 inhibitors (SGLT2), these medications are frequently under prescribed or delayed.Methods: A comprehensive review of peer-reviewed literature published between 2020 and 2025 was conducted. Databases used were CINAHL, PubMed, EBSCOhost, and Elsevier databases. The studies included are randomized controlled trials, cohort studies, retrospective analyses, and quality improvement initiatives. A total of ten articles met the inclusion criteria and were analyzed for methodological quality, key findings, and relevance to the research question.Results: Findings demonstrate that early initiation and optimization of GDMT during hospitalization are associated with reductions in mortality, improvements in cardiac output, improved medication adherence, and decreased short-term readmission rates. Initiating therapy in the inpatient setting helps ensure timely titration and continuity of care as patients transition to the outpatient environment.Conclusions: The evidence supports inpatient initiation of GDMT as an effective strategy to improve outcomes and reduce readmissions in HF patients 65 and older. These findings highlight the vital role of nurses in evidence-based practice, patient education, medication reconciliation, and care coordination to optimize heart failure management and transition of care following hospital discharge.Keywords: GDMT, Heart failure patients, reducing readmissions