Primary care implementation findings across included real-world studies.
| Study | Setting/Population | Key finding | Implementation implication |
|---|---|---|---|
| Underuse of cardiorenal protective agents | Primary care patients with diabetes in Canada | SGLT2 inhibitor use was lower in patients with cardiorenal comorbidities than in those without comorbidities. | High-risk patients may be missed despite having the strongest indication for cardiorenal protective therapy. |
| CAREPRO-T2D | Adults with type 2 diabetes in Portugal | SGLT2 inhibitors were prescribed to 36.0% of patients with heart failure; SGLT2 inhibitors and/or GLP-1 receptor agonists were prescribed to 36.1% of patients with ASCVD. | Prescribing remained suboptimal despite cardiovascular indications. |
| ATLAS Study | Adults with CKD managed in Danish primary care | Primary care physicians’ awareness of SGLT2 inhibitor cardiorenal benefits was reported, but prescribing remained inconsistent. | Awareness alone may be insufficient; workflow-level interventions may be needed. |
| Low use of guideline-recommended cardiorenal protective agents | Adults with type 2 diabetes in Canadian primary care | 66.3% had a cardiorenal indication, but fewer than 25% of eligible patients were prescribed the recommended cardiorenal-protective therapy. | Indicates a large eligibility-treatment gap in primary care. |
| Factors affecting prescription of SGLT2 inhibitors | Primary care physicians in Hong Kong, China | Barriers included knowledge gaps, risk-benefit concerns, perceptions of professional roles, patient preferences, and system constraints. | Multifaceted interventions should address clinician, patient, and system-level barriers. |
| Real-world prescriptions of GLP-1RAs and SGLT2 inhibitors | Adults with type 2 diabetes in Italy | Prescribing was influenced by cardiorenal markers as well as by sex, body mass index, age, and glycemic patterns. | Risk-based prescribing tools may improve the equitable selection of treatments. |
CKD: chronic kidney disease; SGLT2: sodium-glucose cotransporter-2; GLP-1: glucagon-like peptide-1; GLP-1RAs: glucagon-like peptide-1 receptor agonists; ASCVD: atherosclerotic cardiovascular disease. Summary of prescribing patterns, implementation barriers, and practical implications from included real-world studies evaluating SGLT2 inhibitor use in primary care or routine clinical practice. References: [7–12].