March 17, 2025

Study hints at why a medication that benefits kidney patients is not more widely prescribed

A study from British Columbia (B.C.) identifies several reasons as to why a class of drugs known as SGLT2 inhibitors, which is proven to be beneficial for kidney patients, is not more widely prescribed and taken by patients.  

Sodium-glucose cotransporter-2 (SGLT2) inhibitors can reduce kidney patients’ risk of kidney failure, kidney disease progression, and cardiovascular- and kidney-related death, and yet prescriptions and uptake of these medications remain low. For example, studies show that 14 per cent or fewer of patients who would benefit from an SGLT2 inhibitor are prescribed it. To better understand why SGLT2 inhibitors are not more widely prescribed to and used by kidney patients, Dr. Tae Won Yi and colleagues interviewed 21 clinicians whose responses were analyzed for key themes. Barriers to uptake included current perceptions and beliefs, clinician factors, patient factors, medication factors, and health care system factors. 

When interviewed by researchers, participating clinicians expressed varying levels of knowledge of and comfort in prescribing SGLT2 inhibitors and noted that patients have previously voiced concerns about side effects related to the medication and a high pill burden to them. As well, all clinicians interviewed agreed that the out-of-pocket costs associated with SGLT2 inhibitors specifically for kidney disease were a barrier to their use (at least in the province of B.C., where the study was conducted). Several clinicians noted that explaining the potential benefits of SGLT2 inhibitors could improve patient enthusiasm about their use, and that consensus among colleagues, influential leaders, and peers in support of their use, as well as endorsement by national guidelines, could lead to an increase in prescribing rates for SGLT2 inhibitors among doctors who treat kidney patients.