Centre for Diabetology, Endocrinology and Treatment of Metabolic Diseases, Sacra Famiglia Hospital, Erba, Italy.
University of Milano Bicocca, Milan, Italy.
Endocr Metab Immune Disord Drug Targets. 2024;24(12):1422-1430. doi: 10.2174/0118715303294909240221102552.
Compared to Immediate-Release (IR) metformin, Extended-Release (ER) metformin reduces side effects and pill burden while improving adherence; however, there is little real-life data on patient satisfaction with this innovative formulation to guide physicians toward a more holistic approach.
Our goal is to train general practitioners on holistic patient management, with the aim of increasing patient satisfaction and treatment adherence, reducing side effects, and improving quality of life in patients with poor tolerance to metformin-IR.
We designed an educational program for physicians called SlowDiab, aimed at establishing a holistic patient approach. In this context, adult patients with T2DM who experienced gastrointestinal discomfort with metformin-IR were enrolled and switched to metformin- ER. Data on glycemic control were collected at baseline and 2 months after switching. A survey was carried out on patients to assess their level of satisfaction.
In 69 enrolled patients (mean (min-max) age, 68.2 (41-90)), side effects decreased after switching from 61.8% to 16.2% (p < 0.01), and the mean perceived burden of adverse events on a scale of 1 to 10 also decreased (6.17 vs. 3.82; p < 0.05). Among patients previously intolerant to metformin-IR, 74.3% reported no longer experiencing any side effects after the switch. The mean number of tablets taken daily (2.28 vs. 1.66; p < 0.01) and mean plasma glycated hemoglobin (HbA1c) values (7.0% vs. 6.7%; p < 0.05) decreased, while 93.8% of patients were satisfied with the treatment change. Moreover, 84.2% reported an improvement in glycemic control after the switch.
In a real-life setting, an educational program for general practitioners confirmed that metformin ER reduces side effects and improves pill burden, therapeutic adherence, and patient satisfaction compared to metformin IR.
与普通剂型(IR)二甲双胍相比,延长释放剂型(ER)二甲双胍可减少副作用和用药负担,同时提高患者服药依从性;然而,关于这种创新制剂的患者满意度的真实数据很少,无法为医生提供更全面的治疗方案。
我们旨在通过培训全科医生来实现患者的全面管理,从而提高患者满意度和治疗依从性,减少副作用,提高不耐受 IR 型二甲双胍的患者的生活质量。
我们为医生设计了一个名为 SlowDiab 的教育项目,旨在建立一种全面的患者治疗方法。在此背景下,纳入了因胃肠道不适而改用 ER 型二甲双胍的 T2DM 成年患者。在转换后 2 个月时收集了血糖控制数据,并对患者进行了满意度调查。
在 69 名入组患者(平均(最小-最大)年龄,68.2(41-90)岁)中,转换后副作用从 61.8%降至 16.2%(p < 0.01),不良事件感知负担的平均评分(1 到 10)也从 6.17 降至 3.82(p < 0.05)。在先前不耐受 IR 型二甲双胍的患者中,74.3%的患者报告转换后不再出现任何副作用。平均每日服用的片剂数量(2.28 片与 1.66 片;p < 0.01)和平均血浆糖化血红蛋白(HbA1c)值(7.0%与 6.7%;p < 0.05)均降低,93.8%的患者对治疗改变感到满意。此外,84.2%的患者报告转换后血糖控制得到改善。
在真实环境中,针对全科医生的教育项目证实,与 IR 型二甲双胍相比,ER 型二甲双胍可减少副作用,减轻用药负担,提高治疗依从性和患者满意度。