Aims: To explore: 1) Primary Care Physicians’ (PCPs) perspectives regarding initiating SGLT2 inhibitors (SGLT2i) in patients with type 2 diabetes and their current and preferred sources of education about SGLT2i and type 2 diabetes pharmacotherapy more generally; and 2) The support provided to PCPs by Endocrinologists in relation to prescription of type 2 diabetes medications.
Methods: Semi-structured interviews were conducted with 15 PCPs and 12 Endocrinologists working in diverse demographic areas in New South Wales, Australia. A purposive approach was used to recruit PCPs and Endocrinologists. Emergent themes were identified from the transcripts. Interviews were conducted until thematic saturation was reached.
Results: We identified factors contributing to some PCPs’ hesitancy to prescribe SGLT2i. These included an under-appreciation of the cardiovascular and renal benefits of SGLT2i, uncertainty about the role of comparatively new drug classes including SGLT2i, a preference for an Endocrinologist to decide on therapy and patients’ experiences with adverse effects. PCPs expressed a preference to receive education about this topic from Endocrinologists, ideally via case-based discussions. Challenges faced by Endocrinologists in providing education to PCPs included potential constraints on talk content imposed by a pharmaceutical company if speaking at a company-sponsored event (focus being on an individual agent), prioritising time for PCP education, and the need to provide support about other endocrine conditions in addition to diabetes. Several Endocrinologists believed that interactive sessions with PCPs were most useful to PCPs, which could occur virtually.
Conclusion: Despite the evidence for the cardio-renal benefits of SGLT2i, there are barriers to PCPs prescribing these agents. Case-based discussions between PCPs and Endocrinologists about type 2 diabetes treatment including the role of SGLT2i are of great value to PCPs.
T. Milder: None. S. Stocker: Consultant; Self; Nutromics. M. Baysari: None. R. O. Day: None. J. Greenfield: None.
The Heart Foundation (102279)