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Nursing Clinical Information System01:27

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Nursing Clinical Information System (NCIS)
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Increasing SGLT-2 inhibitor prescribing through an integrated case-finding algorithm-guided interdisciplinary

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    Journal of the American Pharmacists Association : Japha
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    Summary
    This summary is machine-generated.

    Interdisciplinary diabetes rounds (IDRs) significantly increased sodium-glucose cotransporter 2 (SGLT-2) inhibitor prescribing by providing PCPs with decision support. An accurate algorithm can target interventions for better population health management.

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    Area of Science:

    • Cardiology
    • Endocrinology
    • Nephrology
    • Population Health Management

    Background:

    • Prescribing of sodium-glucose cotransporter 2 (SGLT-2) inhibitors, crucial for cardiorenal protection, remains suboptimal due to patient and provider barriers.
    • Innovative clinical decision support models are needed to enhance the adoption of SGLT-2 inhibitors.

    Purpose of the Study:

    • To assess the impact of proactive outreach from an interdisciplinary diabetes rounds (IDR) team on SGLT-2 inhibitor prescribing rates.
    • To evaluate a case-finding algorithm for identifying eligible patients for targeted SGLT-2 inhibitor intervention in a population health setting.

    Main Methods:

    • A prospective, observational quality improvement study (October 2021-May 2022) involving IDR team reviews and recommendations sent to primary care providers (PCPs) via electronic health records.
    • Multivariate logistic regression analyzed SGLT-2 inhibitor prescription rates in reviewed versus non-reviewed patients.
    • A secondary analysis assessed the accuracy (sensitivity and specificity) of a case-finding algorithm for SGLT-2 inhibitor eligibility.

    Main Results:

    • The IDR team reviewed 206 patients (mean age 63, 53.9% female, 42.7% Black, mean A1c 8.3%).
    • Patients reviewed by the IDR team showed a significantly higher SGLT-2 inhibitor prescription rate within 90 days (adjusted odds ratio 5.1).
    • The algorithm identified 1084 eligible patients with high sensitivity (90.4%) and specificity (85.1%).

    Conclusions:

    • IDR team interventions significantly increased SGLT-2 inhibitor prescribing rates among eligible patients.
    • A validated algorithm can effectively identify patients for targeted SGLT-2 inhibitor therapy, potentially reducing clinical inertia in population health management.