Impact of an assessment form on promoting in-hospital initiation of sodium–glucose cotransporter-2 inhibitors in hospitalized patients with heart failure

TL;DR

Using an assessment form in hospitals increased the likelihood of prescribing SGLT2 inhibitors to patients with heart failure at discharge.

Contribution

The study demonstrates that an assessment form can effectively promote adherence to recommended therapies for heart failure patients.

Findings

The use of an assessment form was associated with a significantly higher SGLT2i prescription rate at discharge.

Multivariable analysis confirmed the assessment form as an independent factor for SGLT2i initiation.

Implementation of structured forms may improve guideline-directed therapy adherence in hospitalized patients.

Abstract

Despite the established benefits of in-hospital administration of sodium–glucose cotransporter-2 inhibitors (SGLT2i) in patients with heart failure (HF), their implementation remains insufficient. To investigate whether the use of an Assessment Form influences SGLT2i prescriptions at discharge among hospitalized patients with HF.

We retrospectively analyzed consecutive patients with HF from a prospective registry between September 2024 and August 2025 after the implementation of an Assessment Form. Patients who died during hospitalization were excluded. The Assessment Form was completed collaboratively by physicians and nurses. Physicians checked whether guideline-directed medical therapy (including SGLT2i) had been prescribed, and documented the reasons if not initiated, while nurses evaluated the patients’ pre-hospital living conditions and self-care abilities. The primary endpoint was the prescription rate of SGLT2i at discharge according to the Assessment Form.

Among the 208 analyzed patients (median age, 81 years [range, 75–87] years, 59 % male], the Assessment Form was used by 61.1 % (127/208). The prescription rate of SGLT2i at discharge was significantly higher in patients who completed the Assessment Form than in those who did not (65.4 % vs. 45.7 %, p < 0.01). Multivariable logistic regression identified use of the Assessment Form as an independent factor associated with SGLT2i prescription at discharge (odds ratio 2.12, 95 % confidence interval 1.04–4.32, p = 0.03).

Implementation of an Assessment Form was associated with increased initiation of in-hospital SGLT2i therapy. The active use of such structured forms may help promote adherence to guideline-directed therapies during hospitalization for HF.

•SGLT2i initiation in hospitalized patients with HF is important.•Despite this, the use of SGLT2i remains suboptimal in real-world practice.•An assessment form may promote SGLT2i use in hospitalized patients with HF.•The assessment form increased initiation of in-hospital SGLT2i therapy.•Use of such forms may help promote adherence to guideline-directed therapies.

SGLT2i initiation in hospitalized patients with HF is important.

Despite this, the use of SGLT2i remains suboptimal in real-world practice.

An assessment form may promote SGLT2i use in hospitalized patients with HF.

The assessment form increased initiation of in-hospital SGLT2i therapy.

Use of such forms may help promote adherence to guideline-directed therapies.

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