BACKGROUND: Heart failure (HF) and cardiometabolic diseases are a significant global health burden, often coexisting in patients, leading to high morbidity and mortality. The management of these conditions is challenging, and new therapeutic approaches are needed. Sodium-glucose transport protein-2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1)agonists have emerged as promising treatments, demonstrating efficacy in managing both cardiovascular and metabolic outcomes. This study aimed to explore the familiarity, prescribing practices, perceptions, and barriers to the use of SGLT-2 inhibitors and GLP-1 agonists in cardiology practice in Saudi Arabia.
METHODS: A cross-sectional, survey-based study was conducted with cardiology professionals across Saudi Arabia. Participants were invited through convenience sampling from academic and community hospitals, private practices, and multi-specialty clinics. The self-administered online survey assessed demographic characteristics, familiarity with SGLT-2 inhibitors and GLP-1 agonists, prescribing practices, perceived efficacy and safety concerns, barriers to adoption, and support for increased use. Descriptive statistics and logistic regression analysis were used to evaluate the data.
RESULTS: A total of 250 cardiology professionals participated, with 46% (n=115) specializing in heart failure, 30.4% (n=76) in general cardiology, 16.4% (n=41) in interventional cardiology, 4.8% (n=12) in electrophysiology, and 2.4% (n=6) in other cardiology specialties. Regarding familiarity with SGLT-2 inhibitors, 28% (n=70) were very familiar, 46.8% (n=117) were somewhat familiar, and 14.4% (n=36) were not familiar at all. For GLP-1 agonists, 25.6% (n=64) were very familiar, 42% (n=105) were somewhat familiar, and 20.8% (n=52) were not familiar. Prescription practices showed that 10.8% (n=27) of participants always prescribed SGLT-2 inhibitors for heart failure, and 8.8% (n=22) always prescribed GLP-1 agonists for cardiometabolic diseases. Factors influencing prescription practices included the patient's clinical condition (57.6%, n=144), clinical guidelines (51.6%, n=129), and recent clinical trial data (39.6%, n=99). The primary barriers to adoption included high cost or insurance issues (40.8%, n=102) and concerns about side effects (36.4%, n=91).
CONCLUSIONS: Despite the proven efficacy of SGLT-2 inhibitors and GLP-1 agonists, their adoption in cardiology is limited by familiarity gaps, cost concerns, and safety issues. Enhanced education, better access to guidelines, and addressing cost barriers are crucial steps to improve the adoption of these medications in clinical practice.
