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Increasing use of SGLT-2 inhibitors among patients with heart failure
Natalie Hoppe1, Susan Haugh, Audrey Umbreit
1At Mayo Clinic Health System, Natalie Hoppe is an advanced practice registered nurse in the Department of Cardiology in Mankato, MN; Susan Haugh is a nurse practitioner in cardiology and supervisor of cardiology advanced practice providers at multiple locations throughout Minnesota; Audrey Umbreit is a senior pharmacy manager of clinical practice in primary care in the Department of Pharmacy in Mankato, MN; Marisa Morlock is a PA in the Department of Cardiology in Mankato, MN; Jill Sathre is a clinical pharmacist in the Department of Pharmacy in Austin, MN; Jennifer Johnson is a physician in the Department of Family Medicine in Mankato, MN, and medical director of the Medical Weight Management Clinic in Mankato, MN; Katie Machacek is a nurse practitioner in the Department of Cardiology in Austin, MN; Katie Hinderaker is chief of staff at the Mayo Clinic Lake City Medical Center in Lake City, MN, and a consultant in the Department of Family Medicine in Lake City, MN; Ahmad Al-Anii is a physician in the Department of Internal Medicine in Austin, MN; and Alexandra Bates is a performance improvement advisor in Quality Management Services in Mankato, MN. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Objective:
The objective of this quality improvement project was to identify and address barriers contributing to the underutilization of sodium-glucose cotransporter-2 (SGLT-2) inhibitors in eligible patients with heart failure across the health system.
Methods:
The heart failure registry was used to identify the prescription percentage of SGLT-2 inhibitors pre- and postintervention. Interventions to increase prescribing included pharmacist education to primary care providers and use of a cost information handout.
Results:
Following the intervention, SGLT-2 inhibitor prescription for eligible patients improved from 7.1% (n = 630) to 9.0% (n = 814), representing a relative increase of 26.8% from baseline.
Conclusion:
A multimodal approach involving pharmacy and primary care effectively increased SGLT-2 inhibitor prescribing in patients with heart failure. Physician associates, a key part of the primary care workforce, play an important role initiating guideline-directed medical therapy.
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