(1029) The Use of Guideline-directed Medical Therapy for Heart Failure with Reduced Ejection Fraction at a Federally Qualified Health Center

Objectives: • The purpose of this study is to analyze if patients diagnosed with heart failure with reduced ejection fraction (HFrEF) are being prescribed guideline-directed medical therapy (GDMT).
• The purpose of this study is to determine the prescription frequency of angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), angiotensin receptor/neprilysin inhibitor (ARNI), beta-blockers (BB), and sodium-glucose cotransporter 2 (SGLT-2) inhibitor for patients diagnosed with HFrEF at a Federally Qualified Health Center (FQHC)
• The primary objective is to determine the prescription frequency of ACEI, ARB, ARNI, BB, and SGLT-2 inhibitors in patients diagnosed with HfrEF.
• The secondary objectives of this study are to identify the quantity of patients on any of the 3 medications, patients on 1 out of 3 medications, 2 out of 3 medications, or 3 out of 3 medications, and determine the appropriateness of the strength prescribed.

Treatments for HFrEF have include BB to improve heart function, ACEI or ARBs to inhibit the renin-angiotensin-aldosterone system, and SGLT-2 inhibitors to decrease cardiovascular mortality risk.1 These treatments aim to alleviate symptoms, slow disease progression, and improve quality of life. GDMT improves clinical outcomes and decreases mortality in patients with HFrEF. Despite its proven efficacy of the treatments, GDMT is underutilized in clinical practice and optimal pharmacologic management of HFrEF often falls short and does not align with the existing evidence that supports titration of GDMT post-diagnosis of heart failure.

References:
1. Heidenreich P, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure. J Am Coll Cardiol. 2022 May, 79 (17) e263–e421. https://doi.org/10.1016/j.jacc.2021.12.012

Methods: This single-center retrospective cross-sectional study will be conducted within a Federally Qualified Health Center using electronic health records. The data will be pulled from May 1, 2023 to September 1, 2023. Data on names of medications, dose, and frequency will be collected. Specific indications of HFrEF will be filtered using the International Classification of Diseases (ICD) system, or ICD-10 codes. This study includes patients of all ethnicities who are 18 years of age or older diagnosed with HFrEF and on at least one of the medications listed in the objectives. Patients under the age of 18 or pregnant will be excluded. The primary objective will be reported as the percentage of patients appropriately on GDMT medications listed in the objectives. Data will be analyzed using descriptive statistics and odd ratios (OR).

Results: It is anticipated that the findings of this research will suggest a need for education and improvement in prescribing to increase the optimization of ACEI/ARB, ARNI, BB, and SGLT-2 inhibitor use in patients diagnosed with HFrEF in an FQHC.

Conclusions: To be determined.