The Journey of SGLT2i at TJUH - March 3, 2021

Document Type



Media is loading

Publication Date



In this session multiple specialists present quality improvement projects focused on the uptake and usage of SGLT2i medications for patients with diabetes and cardiovascular disease.

Survey and chart review: The evidence shows that SGLT2i should be standard of care for patients with diabetes and cardiovascular disease. TJUH specialists in cardiology, internal medicine (IM), family medicine (FM), and endocrinology were surveyed (100 respondents). Results showed that although most specialists understand the importance of SGLT2i drugs, the comfort level in prescribing them is less than 5 on a scale of 1-10. Most IM and FM respondents reported discomfort in prescribing for reasons ranging from unfamiliarity with the drugs to cost. From a sample of patients with diabetes and cardiovascular disease, only 13% of patients who met criteria were prescribed a SGLT2i drug. Questions to be answered include: what specialty should prescribe these drugs? How can we improve on current practice?


  • A multispecialty task force to develop and disseminate education via e-mail, conferences, lectures.
  • A nurse practitioner (focused on endocrinology and population health) identifies eligible patients via weekly clinic patient chart reviews and notifies providers via the electronic health record. Early results show continued specialist resistance.
  • Follow-up re: resistance reveals that side effects, insurance coverage/prior authorization, and patient costs are key barriers to prescribing.


Yair Lev, MD
Clinical Assistant Professor
Thomas Jefferson University

Mathew Francis, MD
Department of Medicine
Thomas Jefferson University

Christine Clancy, MSN, CRNP, CDE
Jefferson Health
Division of Endocrinology, Diabetes, & Metabolic Diseases

Eric Shiffrin, MD
Assistant Clinical Professor
Division of Endocrinology, Diabetes & Metabolic Diseases
Thomas Jefferson University Hospital


Gregory S. Liptak
Vice President, Quality Improvement Services
American Diabetes Association

Presentation: 1:09:37



This document is currently not available here.