Abstract: TH-PO858
Nephrologists Survey to Learn Prescribing Patterns of Sodium-Glucose Cotransporter 2 Inhibitors (SGLT2i)
Session Information
- CKD: Epidemiology, Risk Factors, Prevention - I
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention
Authors
- Singh, Tripti, University of Wisconsin-Madison, Madison, Wisconsin, United States
- Li, Tingting, Washington University in St Louis, St Louis, Missouri, United States
- Mandelbrot, Didier A., University of Wisconsin-Madison, Madison, Wisconsin, United States
- Poyan-Mehr, Ali, Kaiser Permanente, Oakland, California, United States
Background
SGLT2i decrease proteinuria and slow the progression of CKD. KDIGO recommends using SGLT2i in all diabetic CKD patients (1A recommendation). However, only 10% of diabetic CKD patients are prescribed SGLT2i. Here we surveyed SGLT2i prescribing patterns among nephrologists globally and identify barriers to SGLT2i prescribing.
Methods
We developed a nine-item online questionnaire to understand the causes of SGLT2i underutilization. We collected the responses of the anonymous survey via Qualtrics from nephrologists through the Glomerular Disease Study and Trial Consortium’s (GlomCon) email distribution list, and via Twitter, Facebook, and Instagram.
Results
: We received responses from 153 survey participants. Forty-nine percent of responders were nephrology fellows or recent graduates of past five years and 51% had been practicing for more than five years. 42% of respondents were from the US, and 58% were outside the US. 52% of respondents worked at a university hospital, and 48% were in private practice. 86% of respondents said they spend >50% of their time in clinical practice. 64% of total respondents and 68% of trainees or recent graduates said that they knew the indications for SGLT2i very well. 53% of respondents from the US vs. 80% of respondents outside the US responded that they knew indications of SGLT2i very well (P 0.001). 33.6% of respondents said that they prescribe SGLT2i to>50% of their patients meeting requirements for SGLT2i. There was no difference based on recent graduates vs. practicing nephrologists>5years or US nephrologists vs. non-US nephrologists. The most common barriers to prescribing SGLT2i were the cost of the medication or high co-pay (34%), lack of experience or comfort in prescribing SGLT2i (29%), and lack of time and personnel to manage the side effects (11%). Professional guidelines (29%), readily available medical knowledge through social media (26%), and participation in professional conferences (18%) were identified as the mechanisms that have helped the most in prescribing SGLT2i
Conclusion
SGLT2i prescribing remains low among nephrologists. Major barriers to prescribing SGLT2i include unfamiliarity with drug indication among nephrologists and cost of medication.