dc.contributor.author
Kerwagen, Fabian
dc.contributor.author
Riemer, Uwe
dc.contributor.author
Wachter, Rolf
dc.contributor.author
Haehling, Stephan von
dc.contributor.author
Abdin, Amr
dc.contributor.author
Böhm, Michael
dc.contributor.author
Schulz, Martin
dc.contributor.author
Störk, Stefan
dc.date.accessioned
2024-01-19T09:54:51Z
dc.date.available
2024-01-19T09:54:51Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/42114
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-41839
dc.description.abstract
Background
Guideline-directed medical therapy (GDMT) is the cornerstone in the treatment of patients with heart failure and reduced ejection fraction (HFrEF) and novel substances such as sacubitril/valsartan (S/V) and sodium-glucose co-transporter-2 inhibitors (SGLT2i) have demonstrated marked clinical benefits. We investigated their implementation into real-world HF care in Germany before, during, and after the COVID-19 pandemic period.
Methods
The IQVIA LRx data set is based on ∼80% of 73 million people covered by the German statutory health insurance. Prescriptions of S/V were used as a proxy for HFrEF. Time trends were analysed between Q1/2016 and Q2/2023 for prescriptions for S/V alone and in combination therapy with SGLT2i.
Findings
The number of patients treated with S/V increased from 5260 in Q1/2016 to 351,262 in Q2/2023. The share of patients with combination therapy grew from 0.6% (29 of 5260) to 14.2% (31,128 of 219,762) in Q2/2021, and then showed a steep surge up to 54.8% (192,429 of 351,262) in Q2/2023, coinciding with the release of the European Society of Cardiology (ESC) guidelines for HF in Q3/2021. Women and patients aged >80 years were treated less often with combined therapy than men and younger patients. With the start of the COVID-19 pandemic, the number of patients with new S/V prescriptions dropped by 17.5% within one quarter, i.e., from 26,855 in Q1/2020 to 22,145 in Q2/2020, and returned to pre-pandemic levels only in Q1/2021.
Interpretation
The COVID-19 pandemic was associated with a 12-month deceleration of S/V uptake in Germany. Following the release of the ESC HF guidelines, the combined prescription of S/V and SGLT2i was readily adopted. Further efforts are needed to fully implement GDMT and strengthen the resilience of healthcare systems during public health crises.
en
dc.format.extent
12 Seiten
dc.rights.uri
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subject
Heart failure
en
dc.subject
Sacubitril-valsartan
en
dc.subject
Sodium-glucose co-transporter-2 inhibitors
en
dc.subject
Guideline-directed medical therapy
en
dc.subject
Evidence-based practice
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::615 Pharmakologie, Therapeutik
dc.title
Impact of the COVID-19 pandemic on implementation of novel guideline-directed medical therapies for heart failure in Germany: a nationwide retrospective analysis
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.articlenumber
100778
dcterms.bibliographicCitation.doi
10.1016/j.lanepe.2023.100778
dcterms.bibliographicCitation.journaltitle
The Lancet Regional Health - Europe
dcterms.bibliographicCitation.volume
35
dcterms.bibliographicCitation.url
https://doi.org/10.1016/j.lanepe.2023.100778
refubium.affiliation
Biologie, Chemie, Pharmazie
refubium.affiliation.other
Institut für Pharmazie

refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.isPartOf.eissn
2666-7762
refubium.resourceType.provider
WoS-Alert