Abstract
Background: Sacubitril/Valsartan has gained significant momentum regarding management of heart failure. In the latest 2022 HF guideline, Sacubitril/Valsartan is recommended as a first-line treatment and to replace well-tolerated ACEi/ARB’s. We decided to evaluate current utilization trends with regards to prescription of Sacubitril/Valsartan at our safety-net hospital. Methods: For this retrospective study,a chart review identified Sacubitril/Valsartan use in a total of 769 patients,which was catalogued by drug dose, division use, and prescriber specialty at University Health Truman Medical Center in Kansas City, Missouri from October 1, 2021 thru October 31, 2022. Results: Of the 769 patients prescribed Sacubitril/Valsartan, 497 patients were prescribed the 24 mg/26 mg dose, 193 patients were on 49 mg/51 mg dose, and 79 patients were provided a 97 mg/103 mg dose (Figure 1). Cardiologists were only involved in 23% of all Sacubitril/Valsartan prescriptions while ancillary staff providers including nurse practitioners, physician assistants and pharmacists representing the predominant number of healthcare professionals (50%) prescribing Sacubitril/Valsartan (Figure 2). Conclusion: Despite the robust evidence supporting the benefit of using Sacubitril/Valsartan in HF and the unique opportunity that Cardiologists have in taking ownership in optimizing HF management; our data seems to suggest that prescription rates of Sacubitril/Valsartan by Cardiologists at our institution remains low when compared to other specialties. This may contribute to an undertreatment of high-risk HF patients.
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