Impact of American Diabetes Association 2022 Guidelines on Prescribing Rates of Sodium-Glucose Cotransporter-2 Inhibitors in Ambulatory Care Organization Patients With Type 2 Diabetes

Apr 22, 2024Journal of pharmacy practice

How 2022 Diabetes Guidelines Affected Prescriptions of Blood Sugar-Lowering Drugs for Type 2 Diabetes Patients in Outpatient Care

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Abstract

Of the 10,631 patients with type 2 diabetes and comorbidities, 354 (3.3%) were initiated on a sodium-glucose cotransporter-2 inhibitor (SGLT2i) during the study.

Guideline-based prescribing of SGLT2i increased from five to seven prescriptions per week after the 2022 American Diabetes Association (ADA) guideline publication.
The majority of SGLT2i prescriptions were initiated in the internal medicine department, with additional prescriptions from cardiology and nephrology.
Overall utilization rates of SGLT2i remain low among patients with type 2 diabetes and comorbidities.

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Recent clinical trials and guideline updates have highlighted the efficacy and safety of sodium-glucose cotransporter-2 inhibitor (SGLT2i) use in patients with type 2 diabetes (T2D) and comorbidities including atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD), or heart failure (HF).This study assesses the rates of guideline-based prescribing of SGLT2i in patients with T2D and one or more of the following comorbidities: ASCVD, CKD, or HF, prior to and after the 2022 American Diabetes Association (ADA) guideline publication within the Atrius Health clinical pharmacy, internal medicine, and specialty medicine departments.This is a retrospective chart review of data from the electronic medical record. Patients with the aforementioned criteria were included if they were managed by either the clinical pharmacy department, internal medicine, or specialty medicine departments. Patients were excluded if they did not have any of the comorbidities listed or a form of diabetes other than T2D.Of the 10,631 patients enrolled, 354 (3.3%) were initiated on an SGLT2i during the study. The average number of SGLT2i initiations prior to the 2022 ADA guideline publication was five prescription starts per week. After the guideline publication initiation increased to seven prescription starts per week. Secondary outcomes showed the majority of SGLT2i prescriptions were started in the internal medicine department, followed by cardiology and nephrology.Overall utilization rates of SGLT2i are low but increased after the 2022 ADA guidelines were published. These results suggest opportunities to optimize the use of SGLT2i in this patient population. Background: Objective: Methods: Results: Conclusion:

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Impact of American Diabetes Association 2022 Guidelines on Prescribing Rates of Sodium-Glucose Cotransporter-2 Inhibitors in Ambulatory Care Organization Patients With Type 2 Diabetes

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