Prescribing trends of cardioprotective medications among patients with diabetes and ASCVD in primary care setting in Qatar.

BACKGROUND

Despite established guidelines recommending cardioprotective medications for patients with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD), prescribing practices often fall short of recommendations. In this study we aimed to assess the prescribing trends of guidelines-recommended cardioprotective medications, including sodium-glucose cotransporter-2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1RA), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEi/ARB), and high-intensity statins, among patients with type 2 diabetes mellitus (T2DM) and atherosclerotic cardiovascular disease (ASCVD) in Qatar's primary health care corporation (PHCC).

METHODS

This retrospective cross-sectional study analysed electronic medical records data from 29 PHCC centres in Qatar for the period January-December 2021. Prescription rates of SGLT2i/GLP-1RA, ACEi/ARB, and high-intensity statin were assessed based on documented medication usage. Logistic regression was used to identify factors associated with guideline-directed prescribing. The study received ethics approval from the PHCC in Qatar, with de-identified data accessible only to the Principal Investigator.

RESULTS

Among the 2,870 eligible subjects, only 10% (n = 292) were prescribed high-intensity statins, 12% (n = 357) received SGLT2i/GLP-1RA, and 56% (1,617)were prescribed ACEi/ARB. Male gender, higher HbA1c, and a diagnosis of dyslipidaemia were positively associated with increased likelihood of adherence to relevant clinical practice guidelines. However, these factors only explained only 16% of the observed variance.

CONCLUSION

The majority of patients with T2DM and ASCVD did not receive the completed guideline-recommended regimens of cardioprotective medications, suggesting a significant gap in clinical practice. Urgent implementation of multifaceted strategies is warranted to address barriers and clinical inertia, thereby optimising cardiovascular risk reduction and secondary prevention therapies.