It is increasingly evident that SGLT2 inhibitors (SGLT2i) provide benefits for both patients with diabetes and with heart disease, however these medications are under-prescribed. Over the last few years, an interdepartmental coalition at our hospital has led to several quality improvement projects aimed at increasing SGLT2i use. Our first project focused on increasing prescription of SGLT2i by outpatient cardiologists. Our cardiology department hired a nurse practitioner to review the cardiology patient panels and identify people who might benefit from SGLT2i therapy. She assessed the percent utilization of these drugs - by the end of 24 weeks, she had reviewed 1561 charts and had increased the percentage of patients on an SGLT2i from 9.4% to 10.9%. More importantly, she created a protocol for sending informational messages to providers whose patients were eligible for SGLT2i therapy. Our team also led a project to increase inpatient SGLT2i prescriptions, evaluate barriers to their use, and assess physician comfort with inpatient initiation of therapy. To assess physician comfort with prescribing SGLT2i, we surveyed cardiologists, endocrinologists, and hospitalists regarding prescribing habits and factors preventing SGLT2i inpatient prescription. The most common factors for preventing initiation of SGLT2i therapy included unfamiliarity with evidence for SGLT2i, preference of outpatient initiation, lack of inpatient availability, and cost. To assess whether formulary availability was a barrier to inpatient use, we queried our hospital’s EMR to find the number of inpatient SGLT2i prescriptions before and after dapagliflozin and canagliflozin were added to the hospital formulary. We discovered that adding SGLT2i to our hospital formulary resulted only in a modest increase in the number of SGLT2i prescriptions. Further work needs to be done to increase the utilization of these medications.


A.V.Rivera: None. X.A.Wang: None. M.Grodsky: None. S.Gandhi: None. F.Karaisz: None. Y.Lev: None.

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