Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Sodium-glucose-cotransporter 2 (SGLT2) inhibitors are new medications for type 2 diabetic mellitus (T2DM), and they may reduce the progression rate of chronic kidney disease (CKD). Although the KDIGO 2022 Clinical Practice Guideline has recommended the use of SGLT2 inhibitors for patients with diabetic kidney disease, it is not well-known to what extent these medications are prescribed to these patients in the real world. Therefore, we aim to evaluate the prescription patterns of SGLT2 inhibitors in patients with T2DM and CKD.
Research Question or Hypothesis: What is the guideline adherence of SGLT2 inhibitors in the ambulatory care setting? And what factors are associated with prescribing decisions?
Study Design: A cross-sectional retrospective study was conducted using Chang Gung Research Database from January 2021 to December 2022.
Methods: Outpatients aged over 20 diagnosed with T2DM and CKD were included. We collected patients’ demographics, the use of SGLT2 inhibitors, comorbidities, and laboratory data. The primary outcome was the prescription prevalence as guideline adherence. We used logistic regression to identify factors associated with the use of SGLT2 inhibitors. Statistical analyses were performed using SAS Enterprise Guide version 7.1.
Results: A total of 2,790 patients with T2DM and CKD were included. Guideline adherence percentage was 43.4% with decreased percentages by advanced CKD stages. Throughout the study period, empagliflozin was the most frequently prescribed medication (47.5%), followed by dapagliflozin (42.7%), and canagliflozin (9.8%), respectively. Multivariate analysis revealed that younger people (adjusted odds ratio [aOR] 0.98 [0.97-0.99]), male (aOR 1.40 [1.07-1.84]), hemoglobin A1c >7 (aOR 4.11 [3.46-4.89]), and the CKD early stages were associated with higher chance to prescribe SGLT2 inhibitors.
Conclusion: Our findings showed the prescription patterns had low adherence to KDIGO 2022 guideline. Pharmacist-led interprofessional collaborations and case-based education are warranted to improve guideline adherence and patient care quality.
Presenting Author
Sian-De Liu MSNew Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation)
Authors
Ching-Chung Hsiao MD
New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation)
Chih-Yuan Wu MS
Chang Gung Memorial Hospital