Health care provider experience with canagliflozin in real-world clinical practice: favorability, treatment patterns, and patient outcomes
Health care provider experience with canagliflozin in real-world clinical practice: favorability, treatment patterns, and patient outcomes
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DOI：
10.2147/ijgm.s138583
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发表时间：
2017-01-01
影响因子：
2.3
通讯作者：
Cai, Jennifer
中科院分区：
文献类型：
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作者：
Bolge, Susan C.;Flores, Natalia M.;Cai, Jennifer
目的：本研究描述了现实世界中卫生保健提供者如何使用卡格列净治疗2型糖尿病（T2DM）患者。患者和方法：101名内分泌学家、101名初级保健医生和100名执业护士/医师助理（NP/PAs）完成了一份基于互联网的调查问卷。卫生保健提供者被要求具有使用卡格列净的处方或管理患者的经验，以纳入研究。卫生保健提供者比较了卡格列净与其他T2DM药物的临床特征、成本和患者满意度。还测量了对卡格列净的信心。卫生保健提供者报告了他们的卡格列净处方经验和良好的候选治疗特征。最后，提供者报告了接受卡格列净治疗的患者的预后。所有变量都跨提供者类型进行了比较。结果：与二肽基肽酶-4 （DPP-4）抑制剂相比，卫生保健提供者报告坎格列净对血压和体重的影响更高，对血压、体重、治疗满意度和糖化血红蛋白（HbA1c）的影响比磺脲类药物（SUs）更高，对血压的影响也有差异。卫生保健提供者报告说，他们非常/非常有信心（55%-74%）将卡格列净作为第二到第四线治疗。在描述canagliflozin的良好候选者方面，提供者报告的前3个特征包括关注其体重，保险范围/负担能力以及避免注射治疗。最后，提供者报告经常/总是观察到患者接受卡格列净治疗后HbA1c降低或控制（82%-88%），总体生活质量（QoL; 50%-53%）得到改善。不同类型的提供者在信心、良好的候选特征或患者预后方面没有观察到差异。结论：卫生保健提供者报告了使用卡格列净的良好体验，并见证了患者临床结果和生活质量的改善。
Purpose: This study describes how health care providers approach canagliflozin for the treatment of patients with type 2 diabetes mellitus (T2DM) in the real world. Patients and methods: An Internet-based questionnaire was completed by 101 endocrinologists, 101 primary care physicians, and 100 nurse practitioners/physician assistants (NP/PAs). Health care providers were required to have experience prescribing or managing patients using canagliflozin to be included in the study. Health care providers compared canagliflozin with other T2DM medication classes on clinical characteristics, costs, and patient satisfaction. Confidence in canagliflozin was also measured. Health care providers reported their canagliflozin prescribing experience and good candidate characteristics for treatment. Finally, providers reported on patient outcomes among those receiving canagliflozin. All variables were compared across provider type. Results: Health care providers reported higher favorability for canagliflozin for blood pressure and body weight compared with dipeptidyl peptidase-4 (DPP-4) inhibitors and higher favorability for effect on blood pressure, body weight, treatment satisfaction, and glycosylated hemoglobin (HbA1c) compared with sulfonylureas (SUs), with differences observed for effect on blood pressure. Health care providers reported being very/extremely confident (55%-74%) with canagliflozin as a second-to fourth-line treatment. The top 3 characteristics reported by the providers, in terms of describing a good candidate for canagliflozin, include those concerned about their weight, insurance coverage/affordability, and avoiding injectable treatments. Finally, providers reported often/always observing patients' lowering or controlling HbA1c (82%-88%) and improvement in overall quality of life (QoL; 50%-53%) with canagliflozin treatment. No differences were observed across provider type for confidence, good candidate characteristics, or patient outcomes. Conclusion: Health care providers reported favorable experiences with canagliflozin and witnessed improvements in patients' clinical outcomes and QoL.