EVALUATION OF SACUBITRIL-VALSARTAN THERAPY OUTCOMES AT RUMAH SAKIT DAERAH UMUM KABUPATEN TANGERANG

• Main Author: Aulya Artha Ningrum, Nurul
• Format: Final Project
• Language: Indonesia
• Online Access: https://digilib.itb.ac.id/gdl/view/82627
• Institution: Institut Teknologi Bandung

Heart failure remains a health problem in Indonesia due to high morbidity and mortality rates. Several clinical trials have proven that sacubitril-valsartan is more effective than standard therapy in reducing the risk of hospitalization and death in patients with heart failure with reduced ejection fraction (HFrEF), but its use is still limited in Indonesia. This study aims to analyze the utilization pattern, particulary medication discontinuation as an indication of noncompliance, therapeutic outcomes of sacubitril-valsartan and the demographic relationships with these outcomes using data from hospital in Indonesia. Therapeutic outcomes or endpoints, such as hospitalization or death due to heart failure, were observed over an 8-month period from the initial prescription of sacubitril-valsartan. The study was conducted using an observational method with retrospective cohort study design, involving 111 HFrEF patients in RSUD Kabupaten Tangerang. Data were obtained from pharmacy transactions records, the hospital management information system (SIMRS), and medical records in 2021-2023. The Kaplan-Meier time to event was used to analyze the pattern of drug discontinuation and endpoint events, while Chi-Square and Fisher Exact test were used to analyze the relationship between demographic characteristics and endpoint events. Until the end of the observation period, it was found that the probability of subjects discontinuing sacubitril-valsartan was 21.96% (event=11) and the probability of endpoint occurrence was 25.23% (event=28) (probability of survival of 74.77% and mean of endpoint time is 18,14 weeks). Correlation tests showed a statistically significant relationship (p<0.05) between the presence of comorbidities, specifically diabetes mellitus, hypertension, renal dysfunction, and chronic obstructive pulmonary disease (COPD) with endpoint events. It can be concluded that the use and dosage of sacubitril-valsartan are in accordance with the 2023 PERKI guidelines, there is a high probability of medication discontinuation, and the probability of reaching the endpoint is close to the results of previous studies.