Posters
Presenting Author Academic/Professional Position
PGY-2 Internal Medicine Resident
Academic Level (Author 1)
Fellow
Discipline/Specialty (Author 1)
Internal Medicine
Academic Level (Author 2)
Resident
Discipline/Specialty (Author 2)
Internal Medicine
Academic Level (Author 3)
Resident
Discipline/Specialty (Author 3)
Internal Medicine
Academic Level (Author 4)
Fellow
Discipline/Specialty (Author 4)
Internal Medicine
Academic Level (Author 5)
Faculty
Discipline/Specialty (Author 5)
Internal Medicine
Discipline Track
Patient Care
Abstract Type
Research/Clinical
Abstract
Background: Heart failure (HF) remains a major contributor to morbidity, mortality, and healthcare costs worldwide, particularly in underserved populations. Effective, evidence-based management is crucial to halting disease progression, reducing hospital readmissions, and enhancing quality of life. SGLT2 inhibitors have demonstrated significant clinical benefit in heart failure with both reduced and preserved ejection fraction, regardless of diabetes status. Despite strong guideline support, real-world prescription rates remain suboptimal. This quality improvement (QI) project aimed to evaluate current prescribing patterns of SGLT2 inhibitors in hospitalized CHF patients at Valley Baptist Medical Center (VBMC), identify documentation gaps and barriers, and assess internal medicine residents’ knowledge and comfort with prescribing these medications.
Methods: We conducted a retrospective chart review of patients admitted to VBMC with CHF from August to September 2023. Data were collected on SGLT2 inhibitor use on admission and discharge, documentation of CHF diagnosis, NYHA classification, ejection fraction (EF), and education/counseling notes. Patients with documented contraindications, hospice enrollment, or pregnancy were excluded. A separate anonymous survey assessed resident physicians’ familiarity with SGLT2 inhibitors, perceived barriers, and documentation practices. Descriptive statistics summarized prescription patterns; thematic analysis identified key barriers and gaps in documentation and training.
Results: Among 73 charts reviewed, 32 patients had diabetes and 41 did not; all had a diagnosis of CHF. Only 3 (8.1%) of 37 eligible non-diabetic CHF patients were discharged on SGLT2 inhibitors. Of the 34 patients not on therapy, 20 had no documented contraindications, and only 24 had no recommendations for outpatient SGLT2 initiation or cardiology follow-up. NYHA functional class was documented in only 14.5% of cases, limiting eligibility assessment. Among surveyed residents (N=19), only 63.2% reported any formal education on SGLT2 use during residency. The most common barriers cited included lack of familiarity with guideline recommendations (36.8%), limited experience with prescribing (42.1%), and insurance or cost issues (89.5%). Many were unsure whether the primary or cardiology team should initiate therapy, and 58% did not routinely document NYHA class.
Conclusions: Despite the high burden of heart failure and the availability of therapies proven to slow disease progression, most eligible hospitalized patients at our center were not on SGLT2 on admission or discharge. This highlights missed opportunities to maximize medical management. Barriers included inconsistent documentation of NYHA class and EF, uncertainty regarding who should initiate therapy (hospitalist vs. cardiology vs. PCP), and concerns about insurance coverage. Addressing these issues through a multifaceted approach—including resident-focused education, standardized EMR templates, clearer discharge planning, and systemic clarification of prescribing roles—may increase appropriate initiation, which may help bridge the current practice gap and improve long-term outcomes in this vulnerable population.
Presentation Type
Poster
Recommended Citation
Ngo, Duc Khiem; Swamy, Tejaswini; Alejos Aguero, Carlos; Hassan Memon, Sobia; Garcia, Laura E.; and Ramos, Carlos, "Evaluating SGLT2-Inhibitor Prescribing in Hospitalized Congestive Heart Failure Patients at a Community Teaching Hospital" (2025). Research Colloquium. 105.
https://scholarworks.utrgv.edu/colloquium/2025/posters/105
Included in
Evaluating SGLT2-Inhibitor Prescribing in Hospitalized Congestive Heart Failure Patients at a Community Teaching Hospital
Background: Heart failure (HF) remains a major contributor to morbidity, mortality, and healthcare costs worldwide, particularly in underserved populations. Effective, evidence-based management is crucial to halting disease progression, reducing hospital readmissions, and enhancing quality of life. SGLT2 inhibitors have demonstrated significant clinical benefit in heart failure with both reduced and preserved ejection fraction, regardless of diabetes status. Despite strong guideline support, real-world prescription rates remain suboptimal. This quality improvement (QI) project aimed to evaluate current prescribing patterns of SGLT2 inhibitors in hospitalized CHF patients at Valley Baptist Medical Center (VBMC), identify documentation gaps and barriers, and assess internal medicine residents’ knowledge and comfort with prescribing these medications.
Methods: We conducted a retrospective chart review of patients admitted to VBMC with CHF from August to September 2023. Data were collected on SGLT2 inhibitor use on admission and discharge, documentation of CHF diagnosis, NYHA classification, ejection fraction (EF), and education/counseling notes. Patients with documented contraindications, hospice enrollment, or pregnancy were excluded. A separate anonymous survey assessed resident physicians’ familiarity with SGLT2 inhibitors, perceived barriers, and documentation practices. Descriptive statistics summarized prescription patterns; thematic analysis identified key barriers and gaps in documentation and training.
Results: Among 73 charts reviewed, 32 patients had diabetes and 41 did not; all had a diagnosis of CHF. Only 3 (8.1%) of 37 eligible non-diabetic CHF patients were discharged on SGLT2 inhibitors. Of the 34 patients not on therapy, 20 had no documented contraindications, and only 24 had no recommendations for outpatient SGLT2 initiation or cardiology follow-up. NYHA functional class was documented in only 14.5% of cases, limiting eligibility assessment. Among surveyed residents (N=19), only 63.2% reported any formal education on SGLT2 use during residency. The most common barriers cited included lack of familiarity with guideline recommendations (36.8%), limited experience with prescribing (42.1%), and insurance or cost issues (89.5%). Many were unsure whether the primary or cardiology team should initiate therapy, and 58% did not routinely document NYHA class.
Conclusions: Despite the high burden of heart failure and the availability of therapies proven to slow disease progression, most eligible hospitalized patients at our center were not on SGLT2 on admission or discharge. This highlights missed opportunities to maximize medical management. Barriers included inconsistent documentation of NYHA class and EF, uncertainty regarding who should initiate therapy (hospitalist vs. cardiology vs. PCP), and concerns about insurance coverage. Addressing these issues through a multifaceted approach—including resident-focused education, standardized EMR templates, clearer discharge planning, and systemic clarification of prescribing roles—may increase appropriate initiation, which may help bridge the current practice gap and improve long-term outcomes in this vulnerable population.
