SHM Converge Scientific Abstract ePoster Gallery-Reducing Prescribing Gaps and Improving Adherence With GDMT Using a Unique, Prescription-Oriented Digital Tool Through a Standard Nurse Navigator Program

Reducing Prescribing Gaps and Improving Adherence With GDMT Using a Unique, Prescription-Oriented Digital Tool Through a Standard Nurse Navigator Program

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This study examined whether a standard nurse navigator (NN), equipped with a prescription-focused digital tool that provided real-time medication fill data, could improve guideline-directed medical therapy (GDMT) prescribing and adherence in patients with congestive heart failure (CHF). The project was motivated by the fact that heart failure hospitalizations are common and costly, while adoption of GDMT remains low despite updated 2022 AHA/ACC/HFSA guidelines recommending four medication classes: SGLT2 inhibitors, ARNi/ACEi/ARBs, beta blockers (BB), and mineralocorticoid receptor antagonists (MRAs).<br /><br />Using a pre/post design from September 2023 to June 2024, the team evaluated 383 patients for prescription outcomes and 171 patients for fill outcomes. After nurse navigator intervention, raw counts increased for several therapies, especially SGLT2 inhibitors and MRAs. Prescription odds ratios showed significant improvement for SGLT2 inhibitors (OR 1.88) and MRAs (OR 1.95), while fills improved significantly for SGLT2 inhibitors (OR 2.19), ARNi/ACEi/ARBs (OR 1.62), beta blockers (OR 1.64), and MRAs (OR 1.95).<br /><br />The study found that access to timely, reliable prescription fill data helped nurse navigators better identify gaps in therapy, reinforce education, and contact patients between visits. This resulted in better GDMT prescribing and medication adherence. Notably, the rate of patients filling all GDMT medications after the intervention was 14.51%, which was 7.71% higher than the average reported in the literature.<br /><br />Overall, the findings suggest that combining nurse navigator support with real-time medication data may reduce clinical inertia, improve guideline adoption, and enhance CHF care outcomes.

Asset Subtitle

Ben G. Long

Meta Tag

Author List Ben G. Long, Brooke Brown

Category Research

Concept Guideline-Directed Medical Therapy

Concept Heart Failure

Concept Adherence

Concept Medication Class

Concept ACC/AHA/HFSA Guidelines

Distinguished Non-Finalist

Presenter Organization Magnolia Regional Health Center

Presenting Author Ben G. Long

Track Technology in Hospital Medicine

Keywords

congestive heart failure

nurse navigator

guideline-directed medical therapy

medication adherence

real-time fill data

SGLT2 inhibitors

ARNi ACEi ARBs

beta blockers

mineralocorticoid receptor antagonists

clinical inertia

Guideline-Directed Medical Therapy

Heart Failure

Adherence

Medication Class

ACC/AHA/HFSA Guidelines