Date of Completion
Fall 11-17-2023
Project Type
Integrative Review
Degree Name
FNP
Department
Nursing
Committee Chair/First Advisor
Dr. Nancy Ballard
Abstract
Background: Advancements in technology have increased management options for heart failure (HF) patients. Options include guideline-directed medical therapy (GDMT), left ventricular assist device (LVAD) therapy, and/or heart transplant. Due to resource allocations, the most accessible options for many HF patients include GDMT and LVAD therapy. Authors of this integrative review (IR) sought to examine quality of life (QOL) and hospitalization rate outcomes among patients receiving GDMT versus LVAD therapy.
Methods: 417 articles were screened across multiple databases (CINAHL, Medline, ProQuest, Ovid, PubMed) for inclusion into the integrative review based on inclusion criteria: published within five years, peer-reviewed, written in English, considered adults ages ≥ 18, and considered patients with NYHA HF classification stages III-IV. In total, 13 articles were appraised and thematically analyzed.
Results: IR findings were presented according to identified themes. Results showed that LVAD therapy poses unique risks: social limitations, higher risk for adverse events, and higher hospitalization rates. Results demonstrated that both GDMT and LVAD therapy improve the following outcome measures in HF patients: survivability, QOL, and functional capacity. It was noted among articles discussing GDMT that combination GDMT has superior outcomes when compared to solo GDMT. Limited research was available that directly compared GDMT and LVAD outcomes. Limited research was available surrounding GDMT outcomes.
Conclusions: While effective, LVAD therapy for HF patients incurs greater complication risk when compared to GDMT. Both GDMT and LVAD therapy improve QOL, functional capacity, and survivability among HF patients. More research is warranted regarding direct comparisons between LVAD and GDMT outcomes.