Abstract 12427: Prescribing Patterns of Sodium-Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Agonists in Patients With Type 2 Diabetes at Cardiology, Endocrinology and Primary Care Visits in a Community Health System

Abstract

Introduction: Both SGLT2i and GLP-1 RA are cardio- and kidney-protective, yet their uptake in clinical practice has been poor. Prescribing patterns of these drug classes at cardiology, endocrinology, and primary care visits are not well understood. Research Questions: What proportion of patients with T2DM and ASCVD, HF, or CKD were prescribed an SGLT2i or GLP-1 RA, and which medical visits were these agents prescribed? Aim: To determine the prescribing rates of SGLT2i and GLP-1 RA at cardiology, endocrinology, and primary care visits. Methods: A cross-sectional study using EHR data from Bon Secours Mercy Health clinics across Virginia (2019, 2020, 2021) included patients ≥18 yo with T2DM and either ASCVD, HF, or CKD, and ≥1 outpatient visit. Adults with T1DM, ESRD, pregnancy, or on hospice or palliative care were excluded. Visit-level prescribing rates were compared overall and for each subgroup between cardiology, endocrinology, and primary care visits using generalized linear mixed modeling with a random practice-level effect. A positive prescription was considered a prescription for either medication for the overall analysis and a prescription of the preferred drug class according to comorbidities for each subgroup. The potential dependence between repeated measurements was estimated using a compound symmetric correlation structure. Results: The 22,060 included patients had a mean age of 68 years, 50% female, 41.3% black, 80% ASCVD, 24% CKD, and 27% HF. Overall, prescriptions for either drug class occurred in 17% of the population. Endocrinology visits had the highest prescription rates per visit overall and for each subgroup, while cardiology visits had the lowest prescription rate overall and for each subgroup (Table 1). Conclusion: Overall prescribing rates for SGLT2i and GLP-1 RA were low among adults with T2DM and ASCVD, HF, or CKD. Cardiology visits had the lowest prescription rates (0.3%) versus endocrinology (7.9%) and primary care visits (2.5%).