Utilizing Novel Therapies for Heart Failure: Educational Needs of Healthcare Providers

Which of the following best describes your profession? *

Physician

Physician assistant

Nurse practitioner

Other (please specify)

Which of the following best describes your profession? Other (please specify)

Which of the following best describes your specialty? *

Cardiology – academic setting

Cardiology – community setting

Internal medicine/general practice/primary care

Other (please specify)

Which of the following best describes your specialty? Other (please specify)

Please rate your confidence in implementing the following treatment strategies for heart failure (HF) in your patients. *

on a scale of 1 – 4, with 1 being not confident and 4 being very confident

	1	2	3	4
Aldosterone/mineralocorticoid receptor antagonist (e.g. spironolactone)	Aldosterone/mineralocorticoid receptor antagonist (e.g. spironolactone) - 1	Aldosterone/mineralocorticoid receptor antagonist (e.g. spironolactone) - 2	Aldosterone/mineralocorticoid receptor antagonist (e.g. spironolactone) - 3	Aldosterone/mineralocorticoid receptor antagonist (e.g. spironolactone) - 4
Angiotensin-converting enzyme (ACE) inhibitors (e.g. enalapril)	Angiotensin-converting enzyme (ACE) inhibitors (e.g. enalapril) - 1	Angiotensin-converting enzyme (ACE) inhibitors (e.g. enalapril) - 2	Angiotensin-converting enzyme (ACE) inhibitors (e.g. enalapril) - 3	Angiotensin-converting enzyme (ACE) inhibitors (e.g. enalapril) - 4
Angiotensin receptor blockers (ARBs) (e.g. valsartan)	Angiotensin receptor blockers (ARBs) (e.g. valsartan) - 1	Angiotensin receptor blockers (ARBs) (e.g. valsartan) - 2	Angiotensin receptor blockers (ARBs) (e.g. valsartan) - 3	Angiotensin receptor blockers (ARBs) (e.g. valsartan) - 4
Angiotensin receptor/neprilysin inhibitors (ARNIs) (e.g. sacubitril/valsartan)	Angiotensin receptor/neprilysin inhibitors (ARNIs) (e.g. sacubitril/valsartan) - 1	Angiotensin receptor/neprilysin inhibitors (ARNIs) (e.g. sacubitril/valsartan) - 2	Angiotensin receptor/neprilysin inhibitors (ARNIs) (e.g. sacubitril/valsartan) - 3	Angiotensin receptor/neprilysin inhibitors (ARNIs) (e.g. sacubitril/valsartan) - 4
Beta-blockers (e.g. atenolol)	Beta-blockers (e.g. atenolol) - 1	Beta-blockers (e.g. atenolol) - 2	Beta-blockers (e.g. atenolol) - 3	Beta-blockers (e.g. atenolol) - 4
If (“funny”) current inhibitors (e.g. ivabradine)	If (“funny”) current inhibitors (e.g. ivabradine) - 1	If (“funny”) current inhibitors (e.g. ivabradine) - 2	If (“funny”) current inhibitors (e.g. ivabradine) - 3	If (“funny”) current inhibitors (e.g. ivabradine) - 4

How would you rate your knowledge of the efficacy and safety of the ARNI sacubitril/valsartan as demonstrated by the PARADIGM-HF trial? *

Not knowledgeable

Somewhat knowledgeable

Moderately knowledgeable

Very knowledgeable

How would you rate your familiarity with the 2016 update to ACC/AHA/HFSA guidelines for the use of ARNI as a renin-angiotensin system inhibitor for patients with HF with reduced ejection fraction? *

Not familiar

Somewhat familiar

Moderately familiar

Very familiar

How often do you experience insurance approval delays or denials when prescribing an ARNI (e.g. sacubitril/valsartan) for your patients with HF? *

0% -20% of prescriptions

21% - 40% of prescriptions

41% - 60% of prescriptions

61% - 80% of prescriptions

81% - 100% of prescriptions

I do not prescribe ARNIs in my practice

Assuming costs/reimbursement/formulary coverage WERE NOT an issue, how likely are you prescribe an ARNI (e.g. sacubitril/valsartan) to eligible HF patients? *

How would rate the significance of the following factors as barriers to prescribing/implementing ARNI therapy (e.g. sacubitril/valsartan) in your practice? *

	Not significant at all	Somewhat significant	Moderately Significant	Very significant
Concerns over potential short term adverse events (e.g. angioedema, hypotension)	Concerns over potential short term adverse events (e.g. angioedema, hypotension) - Not significant at all	Concerns over potential short term adverse events (e.g. angioedema, hypotension) - Somewhat significant	Concerns over potential short term adverse events (e.g. angioedema, hypotension) - Moderately Significant	Concerns over potential short term adverse events (e.g. angioedema, hypotension) - Very significant
Cost of therapy/coverage challenges	Cost of therapy/coverage challenges - Not significant at all	Cost of therapy/coverage challenges - Somewhat significant	Cost of therapy/coverage challenges - Moderately Significant	Cost of therapy/coverage challenges - Very significant
Lack of evidence regarding long-term adverse events	Lack of evidence regarding long-term adverse events - Not significant at all	Lack of evidence regarding long-term adverse events - Somewhat significant	Lack of evidence regarding long-term adverse events - Moderately Significant	Lack of evidence regarding long-term adverse events - Very significant
Patient unwillingness to switch therapies	Patient unwillingness to switch therapies - Not significant at all	Patient unwillingness to switch therapies - Somewhat significant	Patient unwillingness to switch therapies - Moderately Significant	Patient unwillingness to switch therapies - Very significant
Uncertainty regarding appropriate dosing/dose titration	Uncertainty regarding appropriate dosing/dose titration - Not significant at all	Uncertainty regarding appropriate dosing/dose titration - Somewhat significant	Uncertainty regarding appropriate dosing/dose titration - Moderately Significant	Uncertainty regarding appropriate dosing/dose titration - Very significant
Uncertainty regarding efficacy data	Uncertainty regarding efficacy data - Not significant at all	Uncertainty regarding efficacy data - Somewhat significant	Uncertainty regarding efficacy data - Moderately Significant	Uncertainty regarding efficacy data - Very significant
Uncertainty regarding who is likely to benefit	Uncertainty regarding who is likely to benefit - Not significant at all	Uncertainty regarding who is likely to benefit - Somewhat significant	Uncertainty regarding who is likely to benefit - Moderately Significant	Uncertainty regarding who is likely to benefit - Very significant

Please rate your confidence regarding the following aspects of If current inhibitors (e.g. ivabradine) in your patients with heart failure *

(on a scale of 1 – 4, with 1 being not confident and 4 being very confident

	1	2	3	4
Determining appropriate dosing/dose titration	Determining appropriate dosing/dose titration - 1	Determining appropriate dosing/dose titration - 2	Determining appropriate dosing/dose titration - 3	Determining appropriate dosing/dose titration - 4
Determining patient eligibility	Determining patient eligibility - 1	Determining patient eligibility - 2	Determining patient eligibility - 3	Determining patient eligibility - 4
Evaluating available efficacy data	Evaluating available efficacy data - 1	Evaluating available efficacy data - 2	Evaluating available efficacy data - 3	Evaluating available efficacy data - 4
Obtaining insurance coverage/reimbursement	Obtaining insurance coverage/reimbursement - 1	Obtaining insurance coverage/reimbursement - 2	Obtaining insurance coverage/reimbursement - 3	Obtaining insurance coverage/reimbursement - 4
Recognizing and managing adverse events	Recognizing and managing adverse events - 1	Recognizing and managing adverse events - 2	Recognizing and managing adverse events - 3	Recognizing and managing adverse events - 4

What are your most significant educational needs regarding the use of novel treatment options for HF, particularly the ARNI sacubitril/valsartan and the If inhibitor ivabradine?

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Utilizing Novel Therapies for Heart Failure: Educational Needs of Healthcare Providers