在心脏病学、内分泌学和初级保健就诊的2型糖尿病患者中，SGLT2抑制剂和GLP-1受体激动剂的处方模式

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings Pub Date : 2025-04-01 DOI:10.1016/j.mayocp.2024.08.026

Dave L. Dixon PharmD , Teresa M. Salgado MPharm, PhD , Amanda Robinson MS , Salvatore Carbone PhD , Tyler D. Wagner PharmD, PhD , Haroon Hyder MD , Bryan Kirschner PharmD , Kerri T. Musselman PharmD , Tonya M. Buffington PharmD , Roy T. Sabo PhD

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引用次数: 0

摘要

目的：确定钠-葡萄糖共转运蛋白-2抑制剂（SGLT2i）和胰高血糖素样肽-1受体激动剂（GLP-1 RA）在心脏病学、内分泌学和社区卫生系统初级保健就诊中的处方率。患者和方法：一项横断面研究使用了弗吉尼亚州Bon Secours Mercy health门诊诊所（2019年、2020年、2021年）的电子健康记录数据，包括18岁及以上患有2型糖尿病和动脉粥样硬化性心血管疾病（ASCVD）、心力衰竭（HF）或慢性肾脏疾病（CKD）的患者，以及一次或多次门诊就诊。排除患有1型糖尿病、4/5期CKD、终末期肾病、透析治疗、妊娠或临终关怀或姑息治疗的成年人。使用具有随机实践水平效应的广义线性混合模型，对心脏病学、内分泌学和初级保健就诊的总体和每个亚组的处方率进行比较。结果：纳入的22,060例患者平均年龄为68岁，50%为女性（n= 11030）， 41.3%为黑人（n= 9100）， 74.8%为医疗保险受益人（n= 16498）。此外，17724例（80.3%）患者患有ASCVD， 5276例（23.9%）患有CKD， 5965例（27.0%）患有HF。总的来说，17.4%的符合条件的患者（n= 3849）开了这两类药物的处方。在原始模型、未调整模型和调整模型中，与内分泌学和初级保健就诊相比，心脏病学就诊的总体处方率和每个诊断亚组的处方率最低。结论：在2型糖尿病合并ASCVD、HF或CKD的成人患者中，SGLT2i和GLP-1 RA的总体处方率较低。有必要进行进一步的研究，以确定障碍和潜在的解决方案，以改善这些疗法的处方。

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Prescribing Patterns of SGLT2 Inhibitors and GLP-1 Receptor Agonists in Patients With Type 2 Diabetes at Cardiology, Endocrinology, and Primary Care Visits

Objective

To determine the prescribing rates of sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) at cardiology, endocrinology, and primary care visits in a community health system.

Patients and Methods

A cross-sectional study using electronic health record data from Bon Secours Mercy Health outpatient clinics across Virginia (2019, 2020, 2021) included patients 18 years and older with type 2 diabetes and atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), or chronic kidney disease (CKD), and one or more outpatient visits. Adults with type 1 diabetes, stage 4/5 CKD, end-stage kidney disease, dialysis treatment, pregnancy, or hospice or palliative care were excluded. Prescribing rates were compared overall and for each subgroup among cardiology, endocrinology, and primary care visits using generalized linear mixed modeling with a random practice-level effect.

Results

The 22,060 included patients had a mean age of 68 years, 50% were female (n=11,030), 41.3% were Black race (n=9,100), and 74.8% were Medicare beneficiaries (n=16,498). In addition, 17,724 patients (80.3%) had ASCVD, 5276 (23.9%) CKD, and 5,965 (27.0%) HF. Overall, prescriptions for either drug class occurred in 17.4% of eligible patients (n=3,849). Cardiology visits had the lowest prescribing rates overall and for each diagnosis subgroup compared with endocrinology and primary care visits in the raw, unadjusted, and adjusted models.

Conclusion

Overall prescribing rates for SGLT2i and GLP-1 RA were low among adults with type 2 diabetes and ASCVD, HF, or CKD. Additional research is warranted to identify barriers, and potential solutions, to improve prescribing of these therapies.

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来源期刊

Mayo Clinic proceedings 医学-医学：内科

CiteScore

16.80

自引率

1.10%

发文量

383

审稿时长

37 days

期刊介绍： Mayo Clinic Proceedings is a premier peer-reviewed clinical journal in general medicine. Sponsored by Mayo Clinic, it is one of the most widely read and highly cited scientific publications for physicians. Since 1926, Mayo Clinic Proceedings has continuously published articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal welcomes submissions from authors worldwide and includes Nobel-prize-winning research in its content. With an Impact Factor of 8.9, Mayo Clinic Proceedings is ranked #20 out of 167 journals in the Medicine, General and Internal category, placing it in the top 12% of these journals. It invites manuscripts on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics.