There is considerable excitement regarding the benefits of using GLP-1RA in high risk populations (prior ASCVD), however translating evidence into practice is often delayed. We sought to assess within our safety net health system the use of GLP-1RA in type 2 diabetes in high-risk patients in order to inform future quality improvement (QI) initiatives. From Sep 2016 to Oct 2019, we identified a total of 4594 patients with diabetes and a diagnosis of ASCVD. Of these, a total of 101 patients (2%) were prescribed a GLP-1RA, while the majority (N=4493) were not. Patients prescribed a GLP-1RA were on average 60±9 years old, 44% were female, 40% Hispanic. Common co-morbidities and characteristics of patients with ASCVD who did, or did not, receive a GLP-1RA prescription are detailed in the Table. Most GLP-1RA prescriptions were generated by Primary Care (57%), Endocrinology (29%), and Cardiology (6%). The large majority of these patients (42%) received charity care from the health system. Patients receiving a GLP-1RA (compared to those that did not) were more often obese and with a diagnosis of nephropathy. Of note is that the ICD diagnoses identifying ASCVD in the medical records are substantially under-reported. Appropriate use of GLP-1RA in patients with documented ASCVD remains very low. This baseline data will guide our QI efforts and focus on implementing evidence-based use of GLP-1RA at the primary care level.
J.N. McNulty: None. U. Gunasekaran: None. I. Lingvay: Consultant; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Intarcia Therapeutics, Janssen Pharmaceuticals, Inc., MannKind Corporation, Novo Nordisk A/S, Sanofi, TARGET PharmaSolutions, Valeritas, Inc. Other Relationship; Self; Novo Nordisk A/S. L. Meneghini: Advisory Panel; Self; Novo Nordisk Inc., Sanofi US. Consultant; Self; Applied Therapeutics, Sanofi US.
