Utilization of SGLT2 Inhibitors in Heart Failure Patients at Sunnybrook Health Sciences Centre

Abstract

Abstract (258 words) Background: Early initiation of guideline-directed medical therapy for heart failure, including sodium-glucose co-transporter 2 inhibitors (SGLT2), is recommended to optimize disease control and patient outcomes. Prior to 2022, Sunnybrook Heath Sciences Centre (SHSC) restricted inpatient prescribing of SGLT2 inhibitors due to the risk of ketoacidosis. A formulary amendment now permits the initiation of SGLT2 inhibitors in hospitalized patients. Objective: To characterize the use of SGLT2 inhibitors for heart failure patients at SHSC and identify gaps in prescribing. Methods: A retrospective chart review was conducted in adult patients admitted to SHSC with a discharge diagnosis of heart failure between January 25, 2023, and May 31, 2023. SGLT2 inhibitor prescribing practices were assessed along with associated factors, including baseline characteristics, and pharmacist involvement during hospitalization. Results: A total of 147 patients were included in this study. SGLT2 inhibitors were prescribed in 49 patients (33%) at discharge and suggested as outpatient management in 17 patients (12%). SGLT2 inhibitors were prescribed more frequently in men than women (46% vs. 21%, respectively). Additionally, SGLT2 inhibitors were prescribed in a higher proportion of patients with heart failure with reduced ejection fraction (63%) compared with heart failure with preserved ejection fraction (29%). Pharmacist involvement in patient care, represented by documentation in the patient chart, was present in 49% of those prescribed SGLT2 inhibitors.
Conclusions: Despite the increased uptake of SGLT2 inhibitors at SHSC, most patients are not initiated on a SGLT2 inhibitor during hospitalization. Opportunities exist to increase the prescribing of SGLT2 inhibitors in female patients and patients with heart failure with preserved ejection fraction.

Description

Pharmacy residents have the opportunity to complete a research project during their residency training, which provides them with skills on how to conduct and manage a research project. Projects often represent an area of interest and need that has been recognized by the host institution’s pharmacy department. Projects are presented as a poster at an annual CSHP Ontario Branch Residency Research Night, and many eventually go on to be published in a peer-reviewed journal.

Keywords

SGLT2 Inhibitors, Heart Failure, Heart Failure with Reduced Ejection Fraction, Heart Failure with Preserved Ejection Fraction

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