Factors affecting prescription of sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus with established cardiovascular disease/ chronic kidney disease in Hong Kong : a qualitative study

Ngai Mui Ng; Yeung Shing Ng; Tsun Kit Chu; Phyllis Lau

doi:10.1186/s12875-022-01928-z

Factors affecting prescription of sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus with established cardiovascular disease/ chronic kidney disease in Hong Kong : a qualitative study

Ngai Mui Ng, Yeung Shing Ng, Tsun Kit Chu, Phyllis Lau

Western Sydney University

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2 I) has cardiorenal protective properties and are recommended for patients with diabetes and established atherosclerotic cardiovascular disease (ASCVD) and/or chronic kidney disease (CKD). Although cardiorenal complications are high in diabetes and pose a signifcant fnancial burden on the Hong Kong health care system, the use of SGLT2 I in these populations remains low. And yet this issue has not been explored in Hong Kong primary care. This study aimed to explore factors afecting primary care doctors' prescribing of SGLT2 I in patients with diabetes and established ASCVD/CKD in Hong Kong. Methods: A phenomenological qualitative research using semi-structured interviews was conducted between January and May 2021 in one Hospital Authority cluster in Hong Kong. Purposive sampling was employed to recruit primary care doctors in the cluster. The Theoretical Domains Framework (TDF) underpinned the study and guided the development of the interview questions. Data was analysed using both inductive and deductive approaches. The Consolidated criteria for reporting qualitative research (COREQ) checklist was used to guide the reporting. Results: Interviews were conducted with 17 primary care doctors. Four overarching themes were inductively identifed: knowledge and previous practice patterns infuence prescription, balancing risks and benefts, doctors' professional responsibilities, and system barriers. The four themes were then deductively mapped to the nine specifc domains of the TDF: knowledge; intention; memory; beliefs about capabilities; beliefs about consequences; goals; role and identity; emotion; and environmental constraints. Most interviewees, to varying extent, were aware of the cardio-renal advantages and safety profle of SGLT2 I but are reluctant to prescribe or change their patients to SGLT2 I because of their knowledge gap that the cardio-renal benefts of SGLT2 I was independent of glyacemic efcacy.

Original language	English
Article number	317
Number of pages	11
Journal	BMC Primary Care
Volume	23
Issue number	1
DOIs	https://doi.org/10.1186/s12875-022-01928-z
Publication status	Published - 2022

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title = "Factors affecting prescription of sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus with established cardiovascular disease/ chronic kidney disease in Hong Kong : a qualitative study",

abstract = "Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2 I) has cardiorenal protective properties and are recommended for patients with diabetes and established atherosclerotic cardiovascular disease (ASCVD) and/or chronic kidney disease (CKD). Although cardiorenal complications are high in diabetes and pose a signifcant fnancial burden on the Hong Kong health care system, the use of SGLT2 I in these populations remains low. And yet this issue has not been explored in Hong Kong primary care. This study aimed to explore factors afecting primary care doctors' prescribing of SGLT2 I in patients with diabetes and established ASCVD/CKD in Hong Kong. Methods: A phenomenological qualitative research using semi-structured interviews was conducted between January and May 2021 in one Hospital Authority cluster in Hong Kong. Purposive sampling was employed to recruit primary care doctors in the cluster. The Theoretical Domains Framework (TDF) underpinned the study and guided the development of the interview questions. Data was analysed using both inductive and deductive approaches. The Consolidated criteria for reporting qualitative research (COREQ) checklist was used to guide the reporting. Results: Interviews were conducted with 17 primary care doctors. Four overarching themes were inductively identifed: knowledge and previous practice patterns infuence prescription, balancing risks and benefts, doctors' professional responsibilities, and system barriers. The four themes were then deductively mapped to the nine specifc domains of the TDF: knowledge; intention; memory; beliefs about capabilities; beliefs about consequences; goals; role and identity; emotion; and environmental constraints. Most interviewees, to varying extent, were aware of the cardio-renal advantages and safety profle of SGLT2 I but are reluctant to prescribe or change their patients to SGLT2 I because of their knowledge gap that the cardio-renal benefts of SGLT2 I was independent of glyacemic efcacy.",

author = "Ng, {Ngai Mui} and Ng, {Yeung Shing} and Chu, {Tsun Kit} and Phyllis Lau",

year = "2022",

doi = "10.1186/s12875-022-01928-z",

language = "English",

volume = "23",

journal = "BMC Primary Care",

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Factors affecting prescription of sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus with established cardiovascular disease/ chronic kidney disease in Hong Kong : a qualitative study. / Ng, Ngai Mui; Ng, Yeung Shing; Chu, Tsun Kit et al.
In: BMC Primary Care, Vol. 23, No. 1, 317, 2022.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Factors affecting prescription of sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus with established cardiovascular disease/ chronic kidney disease in Hong Kong : a qualitative study

AU - Ng, Ngai Mui

AU - Ng, Yeung Shing

AU - Chu, Tsun Kit

AU - Lau, Phyllis

PY - 2022

Y1 - 2022

N2 - Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2 I) has cardiorenal protective properties and are recommended for patients with diabetes and established atherosclerotic cardiovascular disease (ASCVD) and/or chronic kidney disease (CKD). Although cardiorenal complications are high in diabetes and pose a signifcant fnancial burden on the Hong Kong health care system, the use of SGLT2 I in these populations remains low. And yet this issue has not been explored in Hong Kong primary care. This study aimed to explore factors afecting primary care doctors' prescribing of SGLT2 I in patients with diabetes and established ASCVD/CKD in Hong Kong. Methods: A phenomenological qualitative research using semi-structured interviews was conducted between January and May 2021 in one Hospital Authority cluster in Hong Kong. Purposive sampling was employed to recruit primary care doctors in the cluster. The Theoretical Domains Framework (TDF) underpinned the study and guided the development of the interview questions. Data was analysed using both inductive and deductive approaches. The Consolidated criteria for reporting qualitative research (COREQ) checklist was used to guide the reporting. Results: Interviews were conducted with 17 primary care doctors. Four overarching themes were inductively identifed: knowledge and previous practice patterns infuence prescription, balancing risks and benefts, doctors' professional responsibilities, and system barriers. The four themes were then deductively mapped to the nine specifc domains of the TDF: knowledge; intention; memory; beliefs about capabilities; beliefs about consequences; goals; role and identity; emotion; and environmental constraints. Most interviewees, to varying extent, were aware of the cardio-renal advantages and safety profle of SGLT2 I but are reluctant to prescribe or change their patients to SGLT2 I because of their knowledge gap that the cardio-renal benefts of SGLT2 I was independent of glyacemic efcacy.

AB - Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2 I) has cardiorenal protective properties and are recommended for patients with diabetes and established atherosclerotic cardiovascular disease (ASCVD) and/or chronic kidney disease (CKD). Although cardiorenal complications are high in diabetes and pose a signifcant fnancial burden on the Hong Kong health care system, the use of SGLT2 I in these populations remains low. And yet this issue has not been explored in Hong Kong primary care. This study aimed to explore factors afecting primary care doctors' prescribing of SGLT2 I in patients with diabetes and established ASCVD/CKD in Hong Kong. Methods: A phenomenological qualitative research using semi-structured interviews was conducted between January and May 2021 in one Hospital Authority cluster in Hong Kong. Purposive sampling was employed to recruit primary care doctors in the cluster. The Theoretical Domains Framework (TDF) underpinned the study and guided the development of the interview questions. Data was analysed using both inductive and deductive approaches. The Consolidated criteria for reporting qualitative research (COREQ) checklist was used to guide the reporting. Results: Interviews were conducted with 17 primary care doctors. Four overarching themes were inductively identifed: knowledge and previous practice patterns infuence prescription, balancing risks and benefts, doctors' professional responsibilities, and system barriers. The four themes were then deductively mapped to the nine specifc domains of the TDF: knowledge; intention; memory; beliefs about capabilities; beliefs about consequences; goals; role and identity; emotion; and environmental constraints. Most interviewees, to varying extent, were aware of the cardio-renal advantages and safety profle of SGLT2 I but are reluctant to prescribe or change their patients to SGLT2 I because of their knowledge gap that the cardio-renal benefts of SGLT2 I was independent of glyacemic efcacy.

UR - https://hdl.handle.net/1959.7/uws:74406

U2 - 10.1186/s12875-022-01928-z

DO - 10.1186/s12875-022-01928-z

M3 - Article

SN - 2731-4553

SN - 1471-2296

VL - 23

JO - BMC Primary Care

JF - BMC Primary Care

IS - 1

M1 - 317

ER -

Factors affecting prescription of sodium-glucose co-transporter 2 inhibitors in patients with type 2 diabetes mellitus with established cardiovascular disease/ chronic kidney disease in Hong Kong : a qualitative study

Abstract

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