Putting EMPA-REG into practice: a data-driven intervention

Abstract

This project aimed to establish community sodium-glucose co- transporter-2 inhibitor (SGLT2i) prescription rates in people with diabetes (PWD) who meet the EMPA-REG trial criteria. We established eligibility of PWD in two GP practices through primary care electronic record searches and a review of their medical notes. A total of 81 PWD were eligible for the EMPA- REG trial (8.2% of PWD); 46 were not prescribed an SGLT2i (56.8%). These individuals were contacted in a standardised way to discuss medication changes or offered a full diabetic review. The prescription rates obtained from review of medical notes were compared to the GP practice’s national therapeutic indicator (NTI) for drugs indicative of cardiovascular disease and an SGLT2i or glucagon-like peptide 1 agonist. SGLT2i prescription rates obtained from this project are similar to NTIs, validating our data extrapolation. If PWD eligible for an SGLT2i, as per EMPA-REG criteria, but not currently prescribed one were commenced on treatment, we calculated that 74 (85.1 – 53.9) all-cause deaths could be prevented over 3.1 years in the Greater Glasgow and Clyde health board.

The rates of SGLT2i prescription in the community are suboptimal. Data-driven targeted reviews of at-risk PWD are a simple, time-efficient way to increase SGLT2i prescription rates, preventing some deaths with minimal additional workload.