Keywords: Rural Health, Chronic Conditions, SGLT2i

Background:

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) play a crucial role in the management of type 2 diabetes (T2D), chronic kidney disease (CKD), and heart failure (HF) due to their ability to lower blood sugar levels, reduce cardiovascular risks, and support kidney health. Ensuring optimal treatment with SGLT2i is especially important in rural communities, where healthcare access can be limited and effectively managing chronic conditions can be challenging. Proper use of SGLT2i can prevent disease complications and improve disease trajectory, making it essential for healthcare providers in rural areas to offer optimal and consistent care to maximise the benefits of these medications.

Aim of the case report:

The purpose of this case series is to focus on a rural primary care network population, emphasising the importance of optimising treatment with SGLT2is for patients with diabetes, CKD, and HF. It is crucial to identify eligible patients and provide them with the appropriate therapy to enhance their health outcomes.

Case report:

The review was conducted by four general practices, covering a rural population of approximately 39,000 patients. The identification and review process differed slightly between practices that employed various strategies to review patients, including nurse-led clinics, dedicated appointments, ad hoc reviews, and dedicated clinics using the MDT. Seven hundred fifty patients at risk were reviewed, with a 16% increase in the prescribing of SGLT2 Inhibitors across all disease areas.

Conclusions:

It is essential to ensure that eligible patients receive SGLT2is to improve outcomes in conditions such as T2D, HF, and CKD. This case series highlights practical strategies for the proactive identification of patients at the population level. It also addresses the barriers to treatment, aiming to make these therapies accessible to all who can benefit from them, including our older patients.