Heart failure ‘Nudges’ for treatment optimization in the emergency department: the Nudge HF study
Year: 2026
Type: article
Abstract: Most heart failure (HF) patients experience a high risk of re-hospitalizations and mortality after an emergency department (ED) visit for acute or worsening heart failure (AHF).1–3 Many patients with unplanned visits to the ED with signs and symptoms suggestive of AHF remain undiagnosed and undertreated, which further aggravates its poor prognosis.4–6 Natriuretic peptides (NPs) are a backbone diagnostic test for HF and NT-proBNP levels ≥300 pg/mL in the acute setting are highly suggestive of AHF.7 However, even when available, NPs are underutilized in the ED.8 Electronic health-record (EHR) embedded ‘nudges’ integrated as clinical decision support tools may be used to improve decision-making in the ED, where promptly identifying and treating AHF may be challenging.9 Recognizing the central role of NPs for HF diagnosis in the ED, we hypothesized that an automatic NT-pro BNP request would help with HF diagnosis in the ED. Thus, in a tertiary-care hospital in northern Portugal we performed a prospective study with an Applied Behaviour Analysis (ABA) withdrawal experimental design using EHR ‘nudges’ with- and without automated NT-proBNP requests to support HF diagnosis and treatment in the ED.10
DOI: 10.1093/ejhf/xuag123
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7153453202
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