OBJECTIVES

The primary objective of this study was to characterize the persistence of sacubitril/valsartan in a real-world setting of heart failure (HF) patients at 12 months.

METHODS

This was a cross-sectional study of patients with a prescription of sacubitril/valsartan originally identified in Portuguese community pharmacies utilizing primary data collection. Adult HF patients (≥18 years) or caregivers who were recruited for the previously approved PRiMe study were contacted to answer a telephone-based questionnaire (PRiMe 2). Whenever it was unfeasible to reach patients, pharmacists were contacted to support with data collection. Persistence was measured as the proportion of patients continuing therapy after 12 months. Functional status was measured through the self-assessed New York Heart Association (NYHA) questionnaire.

RESULTS

As of July 2020, amongst the 285 patients recruited for PRiMe, we were able to collect sacubitril/valsartan persistence data for 269 patients. The median age of patients was 73 years (IQR=63-79) and 65.1% were male with a median follow-up of 20.4 months (IQR=16.3-24.5). The estimated persistence of sacubitril/valsartan at 12 months was 85.9%. Persistence at 12 months among patients <75 years and patients who were firstly prescribed with sacubitril/valsartan by a cardiologist was higher when compared to patients ≥75 years (p=0.0014) and patients initiating sacubitril/valsartan by a general practitioner (GP) or an internist (p<0.0001), respectively. After a median time of 16.6 months (IQR, 12.5-19.3) of sacubitril/valsartan treatment, 42.7% of patients improved their self-assessed NYHA while 48.5% did not observe HF signs and symptoms progression and maintained their self-assessed NYHA.

CONCLUSIONS

Our findings suggest that sacubitril/valsartan real-world persistence at 12 months was high and that HF patients on treatment with sacubitril/valsartan tend to improve their self-reported functional status.