Abstract: SA-PO032
Factors Influencing SGLT2i Utilization in an Inner-City Public Hospital
Session Information
- Diversity and Equity: Other Research
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Despradel, Luis C., New York City Health and Hospitals Jacobi, Bronx, New York, United States
- Hti Lar Seng, Nang San, New York City Health and Hospitals Jacobi, Bronx, New York, United States
- Jim, Belinda, New York City Health and Hospitals Jacobi, Bronx, New York, United States
Background
Sodium-glucose cotransporter-2 inhibitors (SGLT2i’s) remained underutilized in chronic kidney disease (CKD) patients despite their renoprotective benefits. We present the factors associated with SGLT2i prescription in a public hospital in New York City.
Methods
Cross-sectional analysis of adult primary care patients at Jacobi Medical Center, Bronx, NY was done from Jan 2022 to Dec 2022. The sample included patients with CKD and Type 2 Diabetes Mellitus (T2DM). Exclusion criteria were no medication list and eGFR<20 mL/min/1.73 m2. Descriptive statistics and logistic regression analysis were performed using STATA 18 (StataCorp).
Results
Among 2307 eligible patients, SGLT2i prescription rate was 14%. After controlling for gender, age, and subspecialty follow-up, no significant association was found between the prescription of SGLT2i and the patient's race, language, or coexisting comorbidities/complications. Please see Table 1 for the odds ratios of different significant variables.
Conclusion
Women were found to be prescribed less SGLT2i than men, perhaps due to side effects that affect women not identified in this study. Patients without insurance or with public insurance were more likely to be prescribed. As the drug can be dispensed in our hospital pharmacy for the uninsured as opposed to the need for an onerous prior authorization process for those with insurance; public insurances usually do not require prior authorization. Subspecialized services and hospital physicians increased the likelihood of SGLT2i prescription, perhaps reflecting the higher level of evidence-based application in a teaching hospital. By understanding these factors, we can strategize to enhance the utilization of this class of medications.
Table 1. Logistic Regression SGLT2i Prescription