Heart failure & cardiomyopathiesCross-sectional study
Global trend and predictors of non-labelled sacubitril–valsartan dosing: results from IKNOW-HF survey
- global survey
- validated 26-item IKNOW-HF survey
- voluntary and anonymous
Authors' conclusion
The IKNOW-HF survey reveals a substantial variation between guideline-recommended and real-world prescribing practices, with over 80% of responding clinicians utilizing non-labelled dosing. The higher prevalence among HF specialists likely reflects a pragmatic salvage strategy for advanced HF patients intolerant to standard target doses. These findings highlight the need for further education, pragmatic clinical trials evaluating real-world dosing outcomes, and broader integration of specialized pharmacists to optimize GDMT.
Study context
- Population
- Clinicians treating patients with heart failure (HF)complete responses (70.3%) out of 1829 responses from 76 countries, cardiologists 1031 (80.2%)
- Participants
- 1,285 clinicians
Main finding
As reported in the abstract
Respondents reporting non-labelled dosing
1107 (86.1%)
General cardiologists
326 (90%)
Clinicians in the low- and lower-middle-income countries
195 (96%)
Observational data: associations, not effects.
Further findings
Predictors of non-labelled dosing
| Comparison | OR (95% CI) | P value | |
|---|---|---|---|
| practicing in Asia | 0.347 (0.214–0.563) | ||
| having over 10 years of experience | 0.695 (0.489–0.990) | ||
| presence of a cardiology pharmacist · trended towards a fewer non-labelled prescriptions | 0.542 (0.283–1.039) | P = 0.065 | |
| management by HF specialist · trended towards increased non-labelled usage | 1.443 (0.981–2.122) | P = 0.063 | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Summarised from the published abstract; every number is checked against it