Impact of Pharmacist Intervention on Utilization of SGLT2 Inhibitors in Patients With Heart Failure With an Ejection...

Area of Science:

• Cardiology
• Pharmacology
• Health Services Research

Background:

• Heart failure (HF) is a major global health concern.
• Sodium-glucose cotransporter 2 (SGLT2) inhibitors show promise in reducing hospitalizations and cardiac mortality in HF patients with preserved ejection fraction (HFpEF).
• Optimizing SGLT2 inhibitor use in hospitalized HFpEF patients requires effective interventions.

Purpose of the Study:

• To evaluate the impact of a pharmacist-led monitoring program on SGLT2 inhibitor prescribing for hospitalized patients with heart failure and ejection fraction >40%.
• To identify and analyze documented reasons for withholding SGLT2 inhibitors in this patient population.

Main Methods:

• A single-center, retrospective, pre/post interventional study design was employed.
• Patients hospitalized with heart failure and ejection fraction >40% were identified.
• SGLT2 inhibitor utilization rates and reasons for non-prescription were compared before and after program implementation using Chi-squared or student's t-tests.

Main Results:

• The documented appropriate use of SGLT2 inhibitors significantly increased from 40.9% pre-intervention to 62.7% post-intervention (P < 0.001).
• The primary reasons cited for not prescribing SGLT2 inhibitors were risk of infection and renal dysfunction.
• The pharmacist monitoring program led to increased SGLT2 inhibitor prescribing in eligible heart failure patients.

Conclusions:

• Implementation of a pharmacist monitoring program effectively enhanced SGLT2 inhibitor utilization in eligible hospitalized heart failure patients.
• Increased documentation of prescribing decisions and addressing contraindications contributed to the observed rise in SGLT2 inhibitor use.
• Pharmacist interventions are valuable for optimizing guideline-directed medical therapy in heart failure management.