2226-PUB: A Survey of Primary Care Physicians (PCPs): Knowledge of Cardiovascular Outcomes Trials and Treatment Implications

Abstract

Background: Cardiovascular outcomes trial (CVOT) results have led to changes in diabetes position statements and indications for some glucose-lowering agents. This study aimed to understand PCPs’ knowledge of CVOTs and beliefs about T2D medications for CV disease (CVD). Methods: WebMD, LLC fielded a 23-item online survey from Sept 18-20, 2018 to 47,534 Medscape members who were randomly selected across U.S. internal medicine and family PCPs (quota=500). Results: Overall, 503 of 702 PCPs were eligible and completed the survey. Overall, 39% of respondents were slightly/not at all familiar with the 2018 ADA treatment recommendations for those with T2D and atherosclerotic CVD (ASCVD). Many respondents did not know which CVOT showed superiority for major adverse CV events (26%) or CV mortality (31%). PCPs were most familiar with TECOS and LEADER and least familiar with EXAMINE. Also, 24-58% did not know which CVOTs showed an increased risk of AEs (e.g., amputation, genital infection, pancreatitis, retinopathy, etc.). The main challenges PCPs experienced using T2D agents with CV benefits included insurance coverage (75%), cost (73%), and formulary changes (61%). Using T2D medications with CV benefits was ranked the least important treatment priority by 33% (P<.05; Figure). Conclusions: PCPs have knowledge gaps and treatment barriers using T2D medications for patients with T2D and ASCVD. Disclosure G.E. Dailey: Research Support; Self; Eli Lilly and Company, Novo Nordisk Inc., Sanofi US. Speaker's Bureau; Self; Sanofi US. J. Pak: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc. J.H. Shubrook: Advisory Panel; Self; Intarcia Therapeutics, Inc. Consultant; Self; Eli Lilly and Company, Novo Nordisk Inc. Funding Boehringer Ingelheim; Eli Lilly and Company