Increasing Utilization Of Sodium Glucose Cotransport 2 Inhibitors Use, A Quality Improvement Project

• Published in: Journal of cardiac failure Vol. 29; no. 4; pp. 708 - 709
• Main Authors: Cunningham, Christopher, Jagadeesan, Priya, Okoli, Chimuanya, Mohammed, Mortada, Balakumaran, Kathir, Cook, William
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.04.2023
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2022.10.404

Sodium Glucose Cotransport 2 inhibitors or commonly referred to SGLT2-inhibitors have become a concrete addition to the heart failure community over the past several years. From reports benefits in reducing heart failure admissions, cardiovascular mortality and even slowing the progression of chronic kidney disease. Studies have even shown that SGLT2-inhibitors are safe to be acutely started and the benefits seen are independent of mineralocorticoid antagonist use. However, despite these findings, and even recommendations by the American College of Cardiology and Federal Drug Administration, SGLT2-inhibitors continue to be underutilized. With one study reporting prescribing rates as high as only 14% in 2019. Many factors might be contributing to these low prescribing rates and clinical hesitancy, such as concern for hypoglycemia, needing to adjust baseline diabetic medications prescribed by other providers and concern for noncardiac side effects such as having to counsel on urogenital infections risk, in addition to new guidelines, and costs all playing a factor. With this study, we aim to evaluate and increase utilization of SGLT2 use in those with known heart failure with reduced ejection fraction through multistage inpatient education and initiation prior to hospital discharge. Our hospital system is unique because within our hospital system, we can essentially remove medication costs of SGLT2 inhibitors through a government subsidized drug pricing program. Within our hospital we identified patients with a known ejection fraction of less than 40% and GFR greater than 30ml/min. From there, clinical providers were contacted directly about the patient's eligibility and recommendations from the current literature. Educational material was discussed further in detail using presentations and face to face education. Patients were evaluated at time of discharge and again four weeks after hospital discharge to assess hospital readmission and compliance rates. Results for this project are still ongoing and will be completed before the conference date.