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Abstract Introduction Sodium-glucose cotransporter-2 (SGLT2) inhibitors have been shown to provide cardio-renal benefits beyond mere glycemic control; however, their prescription rates remain suboptimal globally. In Northern Ireland (NI), despite updated guidelines endorsing their use for conditions such as type 2 diabetes (T2D), chronic kidney disease (CKD), heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD), various systemic and knowledge-based barriers obstruct their implementation. This study aims to analyse prescribing patterns and identify the barriers to using SGLT2 inhibitors in primary care settings across NI. Aim To assess healthcare professionals’ (HCPs) prescribing practices, identify barriers, and explore regional challenges influencing SGLT2 inhibitor utilisation in NI’s primary care settings. Methodology A cross-sectional online questionnaire was distributed to GPs, nurses, and pharmacists across NI’s 17 GP Federations (January–March 2025). Participants were recruited via professional leads and Telegram groups, with a target sample of 70 (95% confidence level). The survey evaluated demographics, prescribing habits, guideline adherence, and barriers using Likert scales and clinical scenarios. Ethical approval was obtained (FCBMS-24-133-C). Data were analysed descriptively and inferentially (SPSS v28). Results Among 76 respondents (47.4% pharmacists, 39.5% nurses, 13.2% GPs), prescribing varied by indication: 92.1% prescribed SGLT2 inhibitors for T2D with CKD, but only 31.6% for CKD alone and 47.4% never prescribed for HF without T2D. Over 20% avoided prescribing for T2D patients with established CVD if HbA1c was at target. Key barriers included lack of experience/knowledge and pill burden concerns (50% agreement) and frailty (82.9% deterred). Pharmacists were less likely than doctors/nurses to discontinue therapy after eGFR dips (p = 0.006) or prescribe for HbA1c 86mmol/mol (p = 0.015). Discussion Under prescribing is consistent with global trends, influenced by therapeutic inertia, misconceptions about safety, and the inconsistent implementation of guidelines. To optimise treatments, targeted interventions are essential, including education on the cardio-renal benefits, tools for patient identification, and multidisciplinary support. However, there are limitations, such as potential non-response bias, cross-sectional design, and a regional focus that may limit generalisability. Future research should incorporate qualitative insights and prescription audits to tackle systemic inefficiencies. Enhancing healthcare provider adherence to guidelines could improve outcomes for high-risk populations in Northern Ireland.
McBrien et al. (Sat,) studied this question.