Background: A Quality Improvement Educational Intervention (QIEi) was developed to improve disease management for T2D patients with CVD/CKD who may benefit from SGLT-2i/GLP-1RA. An aim was to assess the change in the number of prescriptions of these two medication classes.
Methods: The QIEi was deployed at two practice sites of a large Integrated Health Care System. A team was formed comprising of endocrinologists and 3 PCPs at each site. EHR data review confirmed the gaps and guided QI project discussions. Process improvements and communication strategies were implemented. All the PCPs at the practice sites (N=18 each) received education on these two medication classes. Cased-based and didactic CME accredited webinars designed to help improve knowledge, decision-making and implement best practices were made available for on-demand participation across the health care system.
Results: Prescription rates of SGLT-2i and GLP-1RA at the intervention (N=4247 baseline, 4033 follow up) and non-intervention sites (N=98637 baseline, 91923 follow up) were obtained pre- and 6 months post QIEi. Odds of GLP-1RA prescription dropped by 2% (p=0.75) at the intervention sites and by 6% (p<0.001) at the non-intervention sites. The decrease was not significantly different across sites (p=0.41). There was a small increase in SGLT2i prescription at the intervention sites (p=0.90), while the odds of use decreased by 3% (p=0.017) at non-intervention sites. This was not significantly different across sites (p=0.54).
Conclusion: No meaningful change in prescriptions post-QIEi at the two intervention sites was observed. While it did improve knowledge and engagement, it did not translate into prescription increases. Perhaps more time is needed to observe system-wide changes and/or other factors need to be considered to increase prescriptions for this patient population. Further studies investigating prescribing barriers are warranted.
P.Rao: None. V.Makin: Speaker's Bureau; Bayer Inc. S.Kawczak: None. P.Lazure: None. J.F.Bena: None. P.Mcfadden: None. G.Jacobs: None. K.M.Pantalone: Consultant; AstraZeneca, Bayer Inc., Corcept Therapeutics, Diasome, Eli Lilly and Company, Merck & Co., Inc., Novo Nordisk, Sanofi, Research Support; Bayer Inc., Merck & Co., Inc., Novo Nordisk, Twin Health, Speaker's Bureau; AstraZeneca, Corcept Therapeutics, Merck & Co., Inc., Novo Nordisk.
Eli Lilly and Company; Merck & Co., Inc.