SHM Converge Scientific Abstract ePoster Gallery-GDMT Is Great . . . If Prescribed: Characterizing Prescribing Trends in Patients Hospitalized With Heart Failure

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This retrospective chart review examined guideline-directed medical therapy (GDMT) prescribing patterns for 73 patients discharged from Thomas Jefferson University Hospital in August 2024 after hospitalization for heart failure requiring intravenous diuretics. Patients were grouped into HFrEF/HFimpEF or HFmrEF/HFpEF, and prescribing of key GDMT medications was assessed at home prior to admission and at discharge.<br /><br />Among the 40 patients with HFrEF/HFimpEF, only 15% were on all four GDMT pillars at admission, and this increased modestly to 18% at discharge. Use of individual therapies at discharge was 45% for SGLT2 inhibitors, 50% for ARNi/ACEi/ARB, 35% for MRA, and 75% for beta blockers. None of the patients reached target doses for all four pillars; target dosing was achieved by 5% for ARNi/ACEi/ARB, 35% for MRA, and 13% for beta blockers. SGLT2 inhibitors have fixed dosing.<br /><br />Among the 32 patients with HFmrEF/HFpEF, SGLT2 inhibitor use was low at admission (19%) and unchanged at discharge. Of the 55 patients discharged home, 29% had prescriptions sent to the hospital’s on-site pharmacy.<br /><br />Overall, GDMT prescribing was suboptimal compared with top-performing institutions. Beta blockers were the most commonly initiated therapy during hospitalization, while SGLT2 inhibitors, ARNi/ACEi/ARB, and MRA were added less frequently. The findings suggest important gaps in both outpatient and inpatient heart failure management and support interventions such as inpatient prescribing protocols, pharmacist-led management, and improved discharge planning to increase medication access and adherence.

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Benjamin Richter

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Author List Alan A. Kubey, Avish Patel, Benjamin Richter, Comfort Elumogo, Joshua Riley, Katherine Freedberg, Marina Gonzalez, Meiqi Luo, Ryan Gardner, Sheraz Qamar, Virginia Gonzalez

Category Research

Concept Heart Failure Exacerbation

Concept Guideline-Directed Medical Therapy

Concept Heart Failure

Concept Heart Failure with Reduced Ejection Fraction

Concept Beta Blocker

Distinguished Non-Finalist

Presenter Organization Department of Medicine, Thomas Jefferson University, Philadelphia, PA

Presenting Author Benjamin Richter

Track Quality Improvement

Keywords

heart failure

GDMT

HFrEF

HFpEF

SGLT2 inhibitors

beta blockers

ARNi

MRA

retrospective chart review

discharge prescribing

Heart Failure Exacerbation

Guideline-Directed Medical Therapy

Heart Failure

Heart Failure with Reduced Ejection Fraction

Beta Blocker