Key result
Pharmacist monitoring program linked to ~22-point increase in appropriate SGLT2 inhibitor use in heart failure.
Why the study?
The impact of a pharmacist monitoring program on the use of SGLT2 inhibitors in patients hospitalized with heart failure and ejection fraction >40% was not established.
Does a pharmacist monitoring program improve the utilization of SGLT2 inhibitors in hospitalized patients with heart failure with an ejection fraction >40%?
Observational
No
Does a pharmacist monitoring program improve the utilization of SGLT2 inhibitors in hospitalized patients with heart failure with an ejection fraction >40%?
Absolute Event Rate: 62.7% vs 40.9%
p-value: p=<0.001
A pharmacist monitoring program significantly increases the utilization and appropriate documentation of guideline-directed SGLT2 inhibitor therapy in hospitalized patients with heart failure and ejection fraction >40%.
Introduction: Heart failure is a leading cause of morbidity and mortality worldwide. Literature suggests that the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors can be beneficial to decrease hospitalizations and cardiac mortality in patients with heart failure with an ejection fraction >40%. Research Question: This study assessed the impact of a pharmacist monitoring program on the use of SGLT2 inhibitors for patients hospitalized with heart failure with an ejection fraction >40%, accounting for documented reasons for not prescribing. Study Design: This was a single-center, retrospective, pre/post interventional study. The pre-intervention cohort was assessed for usage prior to initiation of the pharmacist monitoring program, whereas the post-intervention group was assessed after initiation. Methods: Hospitalized patients were identified retrospectively through a report of intravenous diuretic use on the cardiology floor in conjunction with a documented diagnosis of heart failure and ejection fraction >40%. Data Analysis: Data was assessed via Chi-squared or student’s t-test for comparison between the pre-intervention and post-intervention groups. Results: There was a statistically significant increase in documented appropriate use of SGLT2 inhibitors after implementation of pharmacist monitoring program (40.9% pre-intervention vs 62.7% post-intervention, P = <0.001). The most common reasons they were held was due to risk of infection and renal dysfunction. Conclusion: Implementation of a pharmacist monitoring program was associated with an increase in utilization of SGLT2 inhibitors in eligible patients, driven by an increase in documentation. There was an increase in prescribing in patients that were eligible for the medication.
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Bockstruck et al. (2025) conducted an observational in Heart failure with an ejection fraction >40%. Pharmacist monitoring program vs. Pre-intervention (no pharmacist monitoring program) was evaluated on Documented appropriate use of SGLT2 inhibitors (p=<0.001). Implementation of a pharmacist monitoring program increased documented appropriate use of SGLT2 inhibitors in eligible heart failure patients compared to pre-intervention (62.7% vs 40.9%; P<0.001).
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