Division of General Internal Medicine, Baylor College of Medicine, Houston, TX, USA.
Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
Curr Cardiol Rep. 2022 Jun;24(6):689-698. doi: 10.1007/s11886-022-01694-5. Epub 2022 Mar 29.
To review the factors contributing to underutilization of guideline-directed therapies, identify strategies to alleviate these factors, and apply these strategies for effective and timely dissemination of novel cardioprotective glucose-lowering agents.
Recent analyses demonstrate underutilization of cardioprotective glucose lowering agents despite guideline recommendations for their use. Major contributors to underutilization of guideline-directed therapies include therapeutic inertia, perceptions about side effects, and factors found at the level of the clinicians, patients, and the healthcare system. The recent emergence of several novel therapies, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists, for use in cardiovascular disease provides a unique avenue to improve patient outcomes. To effectively utilize novel cardioprotective glucose lowering agents to improve cardiovascular outcomes, clinicians must recognize and learn from prior barriers to application of guideline-directed therapies. Further endeavors are prudent to ensure uptake of novel agents.
综述导致指南指导的治疗方法未充分利用的因素,确定减轻这些因素的策略,并应用这些策略有效和及时地传播新型心脏保护降糖药物。
尽管有使用指南,但最近的分析表明,心脏保护降糖药物的使用不足。导致指南指导的治疗方法未充分利用的主要因素包括治疗惰性、对副作用的看法以及临床医生、患者和医疗保健系统层面的因素。最近出现了几种新型疗法,如钠-葡萄糖共转运蛋白-2 抑制剂和胰高血糖素样肽-1 受体激动剂,可用于心血管疾病,为改善患者结局提供了独特的途径。为了有效利用新型心脏保护降糖药物来改善心血管结局,临床医生必须认识到并从以前应用指南指导的治疗方法的障碍中吸取教训。进一步的努力是谨慎的,以确保新型药物的应用。