Original Research
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are now part of guideline-directed medical therapy for patients with heart failure (HF) with reduced ejection fraction (HFrEF). However, use of SGLT2i in practice, particularly among hospitalized patients, is unknown.
Research Question or Hypothesis: How many patients with HFrEF were discharged from hospital on an SGLT2i, and has it increased over time?
Study Design: Retrospective, quantitative electronic medical record review of patients with HFrEF admitted to Abbotsford Regional Hospital in Abbotsford, Canada between 2021-2023.
Methods: Included were adult patients with HFrEF (left ventricular ejection fraction =40%) admitted with HF. Data were collected on a randomly-selected cohort of 50 patients each year from 2021-2023. Patients with an estimated glomerular filtration rate <30 mL/min/1.73 m2 were excluded. The primary outcome was proportion of patients discharged on a SGLT2i. Secondary outcomes included the trend in prescribing of SGLT2i from 2021-2023, use of SGLT2i in patients with or without diabetes, and specialization of the prescriber.
Results: In total, 150 patients were included. Mean age was 71 years, 69% were male, 61% had hypertension, 40% had diabetes, and 35% had chronic kidney disease. Forty-three percent had newly diagnosed HF. Use of beta-blockers was 96%, RAAS inhibitors was 85%, and MRAs was 61%. Overall proportion of patients discharged on an SGLT2i was 44%. There was a statistically significant increase in SGLT2i use from 2021 to 2022 (10% versus 38%, odd ratio 5.52, 95% confidence interval 1.86-16.34), and from 2022 to 2023 (38% versus 84%, odds ratio 8.57, 95% confidence interval 3.32-22.09). In 2021, 100% of patients prescribed an SGLT2i had diabetes, which decreased to 47% in 2022 and 45% in 2023. Overall, 97% of SGLT2i were prescribed by a cardiologist.
Conclusion: There was a significant increase in SGLT2i discharge prescriptions between 2021-2023 among hospitalized patients with HFrEF. Utilization in patients with HFrEF but without diabetes also increased over that time period.
Presenting Author
Arden Barry BSc, BSc(Pharm), PharmD, ACPRUniversity of British Columbia
Authors
Perminder Bains MD
Abbotsford Regional Hospital and Cancer Centre
Mike Kandler BSc(Pharm), ACPR
Abbotsford Regional Hospital and Cancer Centre
Gordon Klammer BSc(Pharm), ACPR, BCPS
Abbotsford Regional Hospital and Cancer Centre
Astha Sethi PharmD
Fraser Health
Dale Toews BSc(Pharm), ACPR
Abbotsford Regional Hospital and Cancer Centre