2755-LB: Education and Implementation to Improve Prescription of Guideline-Based Cardiorenal Protective Medications

Introduction and Objective: The 2020 Standards of Medical Care in Diabetes first recommended sodium glucose transport protein 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) for management of type 2 diabetes in patients with comorbid cardiovascular and renal conditions. Subsequent years recommended these medications be used for initial therapy in at risk patients. Real world prescription rates, however, remain low (references). Our objective was to improve cardiorenal protective prescribing rates in patients with type 2 diabetes with comorbid conditions across 5 University of California academic medical centers. Methods: A clinical quality collaborative, UC Diabetes Way Initiative, across several academic health care centers was launched in 2020, sharing education framework, implementation strategies and clinical quality improvement efforts. Percentage of primary care and endocrinology patients aged 18-75 with diabetes with established ASCVD or CKD diagnosis or eGFR <60 in the past 2 years who were on SGLT2i or GLP-1 RA were tracked over time across all sites. Results: Quality improvement efforts focused on education to ordering clinicians; development of at treatment algorithm, learning lunches highlighting rationale and use cases to incorporate cardiorenal protective medications into practice and resources to help with access and ordering of medications, supporting tools such as dot phrases and smart sets to enhance efficiency and effectiveness in getting medications ordered and approved. Of the 57,767 patients with diabetes, 17,806 met inclusion criteria. Baseline cardiorenal protective med prescribing was 26.5% starting in 2020, increasing to 68.5% at the end of 2025. Conclusion: Significant improvements in guideline driven cardiorenal protective medication prescribing can be achieved across at risk patients with type 2 diabetes with quality improvement initiatives focusing on education, supporting resources and tools, and real time data tracking. Disclosure K. Kulasa: None. C. Thorne: None. K. Medders: None.