Improving management of heart failure with reduced ejection fraction with sglt2i's using the latest clinical data: an online education intervention
Authors: Sattin S , Sendaydiego A.M 
Published: October 2021

Abstract

Background
Heart Failure (HF) is a leading and increasing cause of morbidity and mortality worldwide. In the last 20 years, a strong emphasis has been placed on improving survival and quality of life in patients with HF. However, despite substantial therapeutic advances, morbidity, mortality, and hospitalization rates remain high.

Purpose
To determine if an online continuing professional development (CPD) intervention could improve knowledge and confidence of cardiologists and primary care physicians related to: reviewing the latest clinical data on the use of sodium-glucose cotransporter 2 (SGLT2) inhibitors in the management of patients with heart failure with reduced ejection fraction (HFrEF) and exploring the safety profile of SGLT2 inhibitors in HFrEF patients.

Methods
Cardiologists and primary care physicians electively participated in a 30-minute, video-based activity comprising of 4 mini lectures with synchronized slides by expert faculty on the review of clinical data on the use of SGLT2 inhibitors in the management of patients with HFrEF and exploring the safety profile of SGLT2 inhibitors in HFrEF patients. The effects of education were assessed using a repeated pair, pre-assessment/post-assessment study design. For all questions combined, a chi-square test assessed differences from pre- to post-assessment. P-values &lt;0.05 are statistically significant. Cramer's V was used to assess level of educational effect using the range of &lt;0.06 (modest), 0.06–0.15 (noticeable), 0.16–0.26 (considerable), and &gt;0.26 (extensive). The activity launched on November 2, 2020 and data were collected through to December 22, 2020.

Results
Overall significant improvements were seen after education for both cardiologists (N=124; P&lt;0.001; noticeable educational effect, V=0.129) and primary care physicians (N=207; P&lt;0.0001; noticeable educational effect, V=0.113). Pre-assessment, the average correct response rate was 40% for cardiologists and 32% for primary care physicians, while post-assessment average correct response rates increased to 53% and 43%, respectively. Significant improvements were observed in cardiologists' and primary care physicians' knowledge related to the dissemination of the latest clinical data of novel therapies and the mechanistic effects of SGLT2 inhibitors in patients with HFrEF (Table 1).
As a result of the education, 24% of cardiologists and 30% of primary care physicians had a measurable improvement in confidence in their ability to appropriately select patients with HFrEF who could benefit from initiation of SGLT2 inhibitor therapy.

Conclusion
The statistically significant improvements observed in this intervention demonstrate the benefits of using a video-based mini lectures with synchronized slides to increase knowledge and confidence of cardiologists and primary care physicians on SGLT2i's and how these therapies could positively impact the quality of life and clinical outcomes of patients with HFrEF.

Funding Acknowledgement
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Boehringer Ingelheim & Lilly Table 1