Section of Cardiology, Department of Medicine.
Division of General Internal Medicine, Department of Medicine; Houston Center for Innovations in Quality, Effectiveness, and Safety (IQuESt), Houston, Texas.
Am J Cardiol. 2022 Jun 1;172:7-10. doi: 10.1016/j.amjcard.2022.02.013. Epub 2022 Mar 17.
This study used data from the Veterans Affairs administrative and clinical dataset to evaluate determinants of glucagon-like peptide-1 receptor agonist (GLP-1 RA) use among patients with concomitant atherosclerotic cardiovascular disease and diabetes mellitus and an antecedent primary care provider visit. The prevalence of GLP-1 RA use was 8.0%. In multivariable-adjusted models, White race, hypertension, obesity, higher hemoglobin A1c, ischemic heart disease, chronic kidney disease, a higher number of primary care provider visits, and previous cardiology or endocrinology visits were directly associated with GLP-1 RA use. Older age, having a physician primary care provider, and receiving care at a teaching facility were inversely associated with GLP-1 RA use. Our data can help inform targeted interventions to promote equitable access to GLP-1 RA and incentivize the adoption of these disease-modifying agents in high-risk patient populations.
这项研究使用了退伍军人事务部的行政和临床数据集的数据,评估了同时患有动脉粥样硬化性心血管疾病和糖尿病以及有前期初级保健提供者就诊史的患者使用胰高血糖素样肽-1 受体激动剂 (GLP-1RA) 的决定因素。GLP-1RA 的使用率为 8.0%。在多变量调整模型中,白种人、高血压、肥胖、更高的糖化血红蛋白、缺血性心脏病、慢性肾脏病、更多的初级保健提供者就诊次数以及先前的心脏病学或内分泌学就诊与 GLP-1RA 的使用直接相关。年龄较大、有医生作为初级保健提供者和在教学机构接受治疗与 GLP-1RA 的使用呈负相关。我们的数据可以帮助制定有针对性的干预措施,以促进公平获得 GLP-1RA,并鼓励在高危患者群体中采用这些疾病修饰药物。