Drug Use Evaluation of SGLT2 Inhibitor Dapagliflozin on Hypertensive Heart Disease Out-Patients in National Cardiovascular Center Harapan Kita

Abstract

Hypertensive heart disease is a collection of changes in the coronary arteries, left atrium and left ventricle due to the increase in blood pressure. Hypertension increases the risk of congestive heart failure and coronary artery disease. Although SGLT2 inhibitors are an oral antihyperglycemic agent used for the medication of type 2 diabetes mellitus patients, they have significant effect in reducing systolic blood pressure and reducing cholesterol level which increases cardiovascular safety. Therefore one of the members of this group, dapagliflozin is also indicated for heart failure in patients with diabetes. Drug use evaluation of SGLT2 inhibitors for hypertensive heart disease out-patients has never been done before in RS Jantung Harapan Kita. The aim of this study is to perform drug utilization study of dapagliflozin towards hypertensive heart failure, specifically congestive heart failure (CHF) and coronary artery disease (CAD) out-patients in Rumah Sakit Jantung Harapan Kita. The out-patients inclusion criteria were patients that received Forxiga and diagnosed with CHF and/or CAD. The collected data was analysed both quantitatively and qualitatively. The quantitative analysis was done using the ATC/DDD system while the qualitative analysis was done by evaluating possible drug interaction, drug duplication, contraindication and drug appropriateness. The DDD of forxiga acquired through this study was 31.5 DDD/patients/3 months. The result of this study showed high percentages of drug contraindication and inappropriateness with a percentage of 24% and 22%, respectively. The drug interaction data showed very high percentages of closely monitored drug interaction with 92% while serious drug interaction was 29.7%. In conclusion, the usage of forxiga medication towards CHF & CAD out-patients were still inappropriate based on the data collected with a high percentage of contraindication, serious drug interaction and inappropriateness. The Rumah Sakit Jantung dan Pembuluh Darah Harapan Kita needs to recheck the prescription given to the patients for drug duplication, interaction, contraindication and appropriateness.