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Abstract
Aims
To describe patterns and patient-level factors associated with use of SGLT2-inhibitors
(SGLT2i) among adults with diabetes treated in Alberta, Canada
Methods
Using linked administrative datasets from 2014-2019, we defined a retrospective cohort
of adults with prevalent or incident type 2 diabetes with indications for SGLT2is
and who did not have advanced kidney disease (GFR<30) or prior amputation. We described
medication dispensation patterns of SGLT2i over time in the overall cohort and among
the subgroup with cardiovascular disease (CVD). Multivariable logistic regression
was used to determine patient characteristics associated with SGLT2i use.
Results
Of the 341,827 patients with diabetes (mean age 60.7 years; 45.6% female), 107,244
(31.3%) had CVD. The proportion of patients with a SGLT2i prescription increased in
a linear fashion to a maximum of 10.8% (95% CI: 10.7%-10.9%) of the eligible cohort
by the end of the observation period (March 2019). The proportion of filled prescriptions
was similar for patients with CVD (10.4%, 95% CI: 10.1%-10.6%) and for those without
CVD (10.9%, 95% CI: 10.8%-11.0%). Patient characteristics associated with lower odds
of filling an SGLT2i prescription included female sex, older age, and lower income.
Conclusions
Use of SGLT2i is increasing among patients with diabetes but remains low even in those
with CVD. Policy and practice changes to increase prescribing for those in whom SGLT2i
may help to reduce morbidity and mortality related to cardiovascular and renal complications,
particularly older adults.
Keywords
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Article Info
Publication History
Accepted:
August 3,
2022
Received in revised form:
July 20,
2022
Received:
January 17,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Key Messages:
• Use of SGLT2is is increasing among patients with diabetes but remains low even in those with co-occurring CVD.
• Use is very low among older adults and may be improved by removing public drug plan formulary restrictions and enhancing physician education.
• Increasing use of SGLT2is could prevent substantial cardiovascular death and other events in Alberta.
Disclaimer: This study is based in part on data provided by Alberta Health. The interpretation and conclusions contained herein are those of the researchers and do not necessarily represent the views of the Government of Alberta. Neither the Government of Alberta or Alberta Health express any opinion in relation to this study.
Identification
Copyright
© 2022 Canadian Diabetes Association.
