Consensus to Reduce Withdrawal and Improve Adherence with SGLT2i: Consensus TWO SGLT2i Adherence Group

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are a class of medications that have shown significant efficacy in regulating blood glucose levels and providing additional benefits, such as cardiorenal protection. This study aims to analyze the factors leading to nonadherence and discontinuation of SGLT2i treatment and to identify strategies that can enhance patient compliance and reduce withdrawal rates.

This consensus involved an expert committee comprising 14 leading opinion leaders, chosen for their profound expertise and experience in type 2 diabetes mellitus (T2D) and SGLT2i therapy. Prior to the meeting, a comprehensive document-developed through an extensive literature review on current challenges, best practices, and potential strategies for improving adherence and reducing withdrawal of SGLT2i-was distributed to the committee members. This allowed ample time for thorough review and preparation. The expert committee convened virtually multiple times to engage in in-depth discussions on various aspects of SGLT2i adherence and compliance. The finalized manuscript encapsulates the consensus achieved by the experts, presenting actionable recommendations aimed at enhancing adherence and reducing withdrawal rates in SGLT2i therapy.

Based on the literature, several factors contribute to the nonadherence of SGLT2i, including being of Black race, older age (>65 years), high unemployment rate, lower income levels, extended duration of diabetes, a greater number of baseline comorbidities, genital infections, and limited access to healthcare facilities. To maintain good adherence, appropriate patient selection and education are essential. Healthcare practitioners should be well-informed about the drug's indications, interactions, and side effects.

Regular monitoring, lifestyle adjustments, and open communication between healthcare practitioners and patients are crucial. Developing personalized care plans, educating patients, promptly addressing their concerns, and cultivating a collaborative healthcare relationship are critical in maintaining adherence.