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Background

Heart failure is associated with high mortality and hospital readmissions. Beta‐adrenergic blocking agents, angiotensin converting enzyme inhibitors (ACEIs), and angiotensin receptor blockers (ARBs) can improve survival and reduce hospital readmissions and are recommended as first‐line therapy in the treatment of heart failure. Evidence has also shown that there is a dose‐dependent relationship of these medications with patient outcomes. Despite this evidence, primary care physicians are reluctant to up‐titrate these medications. New strategies aimed at facilitating this up‐titration are warranted. Nurse‐led titration (NLT) is one such strategy.

Objectives

To assess the effects of NLT of beta‐adrenergic blocking agents, ACEIs, and ARBs in patients with heart failure with reduced ejection fraction (HFrEF) in terms of safety and patient outcomes.