Authors (including presenting author) :
So WT(1), Tse KY(1), Fan SY(1), Liu HK(1)
Affiliation :
(1)Pharmacy, Pamela Youde Nethersole Eastern Hospital
Introduction :
A growing trend of SGLT2 inhibitors usage is observed due to its proven efficacy to improve cardiovascular outcome, reduce heart failure related hospitalisation and weight reduction. This is the first local SGLT2 inhibitors utilisation evaluation carried out in a local hospital.
Objectives :
(1) To evaluate prescribers’ compliance to Hospital Authority Drug Formulary (HADF) on initiation and discontinuation of SGLT2 inhibitors. (2) To investigate the change of haemoglobin A1c (HbA1c) and estimated glomerular filtration rate (eGFR) 6-8 months after initiation of SGLT2 inhibitors.
Methodology :
This was a retrospective study on Type 2 Diabetes Mellitus (DM) adult patients following up in Pamela Youde Nethersole Eastern Hospital who were taking SGLT2 inhibitors, either Dapagliflozin or Empagliflozin, between 1 February 2019 to 30 April 2019. Patients who started SGLT2 inhibitors in private settings, had poor drug compliance, or no HbA1c tested within one year since SGLT2 inhibitors initiation were excluded. Primary outcome was prescribers’ compliance to HADF. Secondary outcome was the changes in HbA1c and eGFR 6-8 months after SGLT2 inhibitors initiation.
Result & Outcome :
A total of 610 patients (Dapagliflozin n=233; Empagliflozin n=377) were enrolled for the study. Overall compliance rate of SGLT2 inhibitors initiation according to HADF was 93.94%. It was found that DM medications were most commonly prescribed in the following sequence: 1st Metformin, 2nd Sulphonylurea, 3rd DPP4 inhibitors or thiazolidinediones or SGLT2 inhibitors, and then 4th alpha-glucosidase inhibitors. SGLT2 inhibitors were most commonly prescribed as the third or fourth agent. Mean change of HbA1c and eGFR were -1.15% and -0.46ml/min/1.73m2 respectively after 6-8 months of SGLT2 inhibitor initiation. 5.25% (n=37) patients discontinued SGLT2 inhibitors, 12 patients due to urinary tract infection or genital area itchiness and 1 patient developed diabetic ketoacidosis. Overall prescribers’ compliance rate to HADF is high and SGLT2 inhibitors improved HbA1c with minimal reduction in eGFR.
