PMID- 34007585
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220423
IS  - 2155-0417 (Electronic)
IS  - 2155-0417 (Linking)
VI  - 10
IP  - 4
DP  - 2019
TI  - Type 2 Diabetes Prescribing Habits amongst Providers to an Underserved 
      Population.
LID - 10.24926/iip.v10i4.2151 [doi]
AB  - INTRODUCTION: Type 2 diabetes mellitus (T2DM) affected over 30 million 
      individuals in the United States as of 2015. Due to the national diabetes 
      guidelines recommending drug selection based on several patient specific factors 
      and varying formulary restrictions, prescribers are often inundated when 
      selecting treatment. Currently, limited evidence is available regarding the 
      primary factors influencing prescribers' drug therapy selection. OBJECTIVES: The 
      purpose of this study was to identify factors that influence providers during 
      T2DM medication selection. METHODS: The study was conducted with providers at a 
      large, academic, safety net health system. All prescribers were sent an 
      electronic, optional and anonymous survey. Prescribers treating T2DM in 
      non-pregnant adult patients were the only prescribers assessed. Factors evaluated 
      were: cost, A1c, comorbidities, adherence, weight, tolerability, patient 
      limitations, and use of guidelines. RESULTS: A total of 86 prescribers responded, 
      yielding a response rate of 31%. The respondents included physicians (56.3%), 
      nurse practitioners (21.8%), medical residents (18.4%), and fellows (3.4%); with 
      the majority practicing in internal or family medicine (47.1%). The most 
      frequently prescribed T2DM medications included: metformin (83.8%), insulin 
      (78.1%), and sulfonylureas (64.8%). Cost and A1c elevation were two of the major 
      factors influencing prescribing of metformin (94.1% and 81.2%), insulin (57.4% 
      and 69.6%), and sulfonylureas (81.2% and 89.9%) respectively. Due to cost 
      concerns, respondents reported rarely or never prescribing glucagon-like 
      peptide-1 agonists (GLP-1RA) and sodium-glucose co-transporter-2 inhibitors 
      (SGLT2i) despite recognizing benefits on diabetes related comorbidities. 
      CONCLUSION: Although current literature from the national guidelines encourages 
      the use of GLP-1RA and SGLT2i as first-line options after metformin in T2DM, 
      these classes of medications were not reported among the most commonly prescribed 
      despite providers correctly identifying positive medication attributes such as 
      cardio- and nephroprotection and weight loss. However, cost of these medications 
      appears to outweigh the benefits when selecting medication therapy.
CI  - (c) Individual authors.
FAU - King, Cynthia A
AU  - King CA
AD  - MetroHealth System; Northeast Ohio Medical University.
FAU - Fontem, Atem A
AU  - Fontem AA
AD  - MetroHealth System.
FAU - King, Benjamin S
AU  - King BS
AD  - MetroHealth System.
FAU - Gothard, David
AU  - Gothard D
AD  - Data Analysis for Clinical Research Studies.
LA  - eng
PT  - Journal Article
DEP - 20191031
PL  - United States
TA  - Innov Pharm
JT  - Innovations in pharmacy
JID - 101574764
PMC - PMC8051893
OTO - NOTNLM
OT  - Type 2 diabetes mellitus
OT  - clinical decision making
OT  - comorbidities
OT  - prescribing habits
OT  - treatment choices
COIS- Conflicts of interest: The authors declare no conflicts of interest.
EDAT- 2019/10/31 00:00
MHDA- 2019/10/31 00:01
PMCR- 2019/10/31
CRDT- 2021/05/19 06:50
PHST- 2021/05/19 06:50 [entrez]
PHST- 2019/10/31 00:00 [pubmed]
PHST- 2019/10/31 00:01 [medline]
PHST- 2019/10/31 00:00 [pmc-release]
AID - 10.24926/iip.v10i4.2151 [doi]
PST - epublish
SO  - Innov Pharm. 2019 Oct 31;10(4):10.24926/iip.v10i4.2151. doi: 
      10.24926/iip.v10i4.2151. eCollection 2019.