From the Guidelines
A retrospective study evaluating SGLT2 inhibitor prescribing patterns in heart failure with preserved ejection fraction (HFpEF) should be designed to analyze medical records from multiple healthcare centers over a 3-5 year period, as recommended by the most recent guidelines 1.
Study Design
The study would include adult patients (≥18 years) with documented HFpEF (ejection fraction ≥50%) and examine prescribing rates of SGLT2 inhibitors including empagliflozin, dapagliflozin, canagliflozin, and ertugliflozin.
- Primary outcomes would assess:
- Overall prescription rates
- Timing of initiation relative to HFpEF diagnosis
- Specific agent selection
- Dosing patterns
- Patient characteristics influencing prescribing decisions
- Secondary outcomes would include:
- Adherence rates
- Discontinuation reasons
- Concurrent medication use
Data Collection
Data collection would involve:
- Demographic information
- Comorbidities (especially diabetes, kidney disease, and cardiovascular conditions)
- Laboratory values (HbA1c, eGFR, BNP/NT-proBNP)
- Hospitalization history
Statistical Analysis
Statistical analysis would include:
- Descriptive statistics
- Multivariate regression to identify prescribing predictors
- Time-trend analysis to detect changes following guideline updates, such as those recommended by the 2022 AHA/ACC/HFSA guideline for the management of heart failure 1 This design is appropriate because SGLT2 inhibitors have shown cardiovascular benefits in recent trials, but real-world prescribing patterns may not align with evidence-based recommendations, as noted in the 2024 update to the 2020 ACC/AHA clinical performance and quality measures for adults with heart failure 1. Understanding current practices can identify gaps in guideline implementation and inform targeted educational interventions to optimize SGLT2 inhibitor use in HFpEF management.
From the Research
Study Design for Retrospective Study Evaluating Prescribing Patterns of SGLT2 Inhibitors in HFpEF
- The study will utilize a retrospective design to analyze the prescribing patterns of SGLT2 inhibitors in patients with heart failure with preserved ejection fraction (HFpEF) 2, 3.
- The study population will consist of patients with HFpEF who have been prescribed SGLT2 inhibitors, and the data will be collected from electronic health records or medical databases 2, 4.
- The study will aim to evaluate the factors associated with the prescribing of SGLT2 inhibitors in HFpEF patients, including demographics, comorbidities, and clinical characteristics 2.
- The study will also examine the outcomes of SGLT2 inhibitor use in HFpEF patients, including all-cause mortality, cardiovascular hospitalization, and kidney function 3, 5.
- The data analysis will involve descriptive statistics, regression analysis, and survival analysis to identify the predictors of SGLT2 inhibitor prescribing and the outcomes of interest 2, 3.
Inclusion and Exclusion Criteria
- Inclusion criteria: patients with HFpEF who have been prescribed SGLT2 inhibitors, with available electronic health records or medical database data 2, 4.
- Exclusion criteria: patients with missing or incomplete data, or those who have not been prescribed SGLT2 inhibitors 2, 4.
Data Collection and Management
- Data will be collected from electronic health records or medical databases, and will include patient demographics, clinical characteristics, medication use, and outcomes 2, 4.
- Data management will involve data cleaning, coding, and analysis using statistical software 2, 3.
Statistical Analysis
- Descriptive statistics will be used to summarize patient characteristics and SGLT2 inhibitor prescribing patterns 2, 3.
- Regression analysis will be used to identify the predictors of SGLT2 inhibitor prescribing and the outcomes of interest 2, 3.
- Survival analysis will be used to examine the time-to-event outcomes, such as all-cause mortality and cardiovascular hospitalization 3, 5.