Prescribing trends of cardioprotective medications among patients with diabetes and ASCVD in primary care setting in Qatar

Résumé fourni par la source

Background: Despite established guidelines recommending cardioprotective medications for patients with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD), prescribing practices often fall short of recommendations. In this study we aimed to assess the prescribing trends of guidelines-recommended cardioprotective medications, including sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB), and high-intensity statins, among patients with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD) in Qatar's primary health care corporation (PHCC). Methods: This retrospective cross-sectional study analysed electronic medical records data from 29 PHCC centres in Qatar for the period January-December 2021. Prescription rates of SGLT2i/GLP-1RA, ACEi/ARB, and high-intensity statin were assessed based on documented medication usage. Logistic regression was used to identify factors associated with guideline-directed prescribing. The study received ethics approval from the PHCC in Qatar, with de-identified data accessible only to the Principal Investigator. Results: = 357) received SGLT2i/GLP-1RA, and 56% (1,617)were prescribed ACEi/ARB. Male gender, higher HbA1c, and a diagnosis of dyslipidaemia were positively associated with increased likelihood of adherence to relevant clinical practice guidelines. However, these factors only explained only 16% of the observed variance. Conclusion: The majority of patients with T2DM and ASCVD did not receive the completed guideline-recommended regimens of cardioprotective medications, suggesting a significant gap in clinical practice. Urgent implementation of multifaceted strategies is warranted to address barriers and clinical inertia, thereby optimising cardiovascular risk reduction and secondary prevention therapies.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.