A pharmacist-led outreach program nearly doubled SGLT2 inhibitor uptake among patients with type 2 diabetes and chronic kidney disease, according to a new study in JAMA Network Open. Patients who received a mailed letter and a 30-minute pharmacist phone consultation were almost twice as likely to fill a prescription compared to those in usual care. Despite the prescribing boost, no significant differences in clinical outcomes were observed over the 12-month follow-up.
Despite strong guideline recommendations, SGLT2 inhibitors — drugs proven to slow kidney disease progression and improve survival — remain dramatically underprescribed. A 2024 analysis of 28 US health systems found that none had a prescribing rate above 25% for patients with a Class 1A recommendation. A new quality improvement study published in JAMA Network Open tested whether pharmacist-led outreach could help close that gap.
The study enrolled 8,658 veterans with type 2 diabetes and chronic kidney disease across eight VA health systems. Patients in the intervention group received a mailed letter about SGLT2 inhibitor benefits and a 30-minute pharmacist phone consultation, with eligible patients prescribed empagliflozin. At 12 months, nearly twice as many intervention patients filled a prescription compared to those receiving usual care — though no significant differences in clinical outcomes like mortality, kidney failure, or heart failure were detected.
Researchers attribute the lack of clinical benefit to the short follow-up period and the fact that only about a quarter of assigned patients actually received the intervention. Experts emphasize that pharmacist-led efforts should be part of a broader interdisciplinary approach.
By the Numbers
Why it matters: With SGLT2 inhibitors offering major kidney and cardiovascular benefits, scalable strategies like pharmacist outreach could meaningfully reduce the prescribing gap — but longer follow-up and better patient engagement tools are needed to confirm real-world clinical impact.
