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Variations in Metformin Prescribing for Type 2 Diabetes
Tiffany Goldberg1, Miranda E Kroehl1, Kathleen Heist Suddarth1
1From the Skaggs School of Pharmacy and Pharmaceutical Sciences, Department of Clinical Pharmacy (TG, KET), the School of Public Health (MEK), and the School of Medicine, Department of Medicine (KHS, KET), University of Colorado, Aurora.
Journal of the American Board of Family Medicine : JABFM
|November 8, 2015
Summary
Provider attitudes on prescribing metformin for type 2 diabetes are suboptimal, varying widely. Many providers hesitate due to perceived risks, impacting optimal patient care and treatment adherence.
Area of Science:
- Endocrinology
- Pharmacology
- Clinical Practice
Background:
- Suboptimal metformin prescribing may stem from concerns about lactic acidosis risk.
- Understanding provider attitudes is crucial for improving metformin use in type 2 diabetes.
Purpose of the Study:
- To investigate healthcare provider attitudes towards metformin prescribing in diverse clinical scenarios.
- To identify factors influencing metformin prescription decisions.
Main Methods:
- Anonymous electronic survey distributed to 76 healthcare providers nationwide.
- Survey assessed prescribing habits for metformin in type 2 diabetes across various patient conditions.
Main Results:
- Most providers (75%) would increase metformin dose for suboptimal glycemic control; 25% would add other agents.
- Prescribing decisions vary significantly based on renal function, hepatic dysfunction, alcohol use, and heart failure.
- 51% use serum creatinine, while others rely on glomerular filtration rate for metformin discontinuation.
Conclusions:
- Provider attitudes towards metformin prescribing are inconsistent and often suboptimal, despite its cardiovascular benefits.
- Significant variation exists in how providers manage metformin in patients with renal, hepatic, or cardiac conditions.
- Addressing provider concerns and standardizing guidelines could optimize metformin utilization.
Keywords:
Health Care SurveysLactic AcidosisMetforminPhysician's Practice PatternsType 2 Diabetes MellitusMore Related Videos
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