Optimising best-practice use of cardiometabolic medicines in Australia using big data

Project Summary

The prevalence of diabetes, cardiovascular disease and kidney disease is increasing in Australia, with these conditions often coexisting. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are medicines initially used for diabetes, now expanded for use as cardiometabolic medicines given their life-saving capacity to reduce disease progression, cardio-renal events and hospitalisation. However, less than half of eligible people are using SGLT2i in Australia possibly due to safety concerns in prescribing those medicines for specific population groups, under-appreciation of the cardio-renal benefits and lack of confidence in initiating those medicines within different specialties.

We will address the mismatch between a highly efficacious medicine class (SGLT2i) that is listed for public subsidy and their use in eligible populations of NSW. Our project will address prescribers’ and policymakers’ concerns related to SGLT2i use and generate evidence to support multi-disciplinary care of people with cardiometabolic conditions, ultimately leading to reduced disease progression, and improved health outcomes and reduced hospitalisations.

Project Date

Jan 2024 - Dec 2026

Investigators

Project Lead

Collaborators

Dr Jialing Lin - UNSW Sydney

Dr Tamara Yael Milder - UNSW Sydney

Dr Brendon Neuren - The George Institute 

Dr Michael Falster – UNSW Sydney

A/Prof Alys Havard - UNSW Sydney

Dr Alice Gibson - Universtiy of Sydney

PhD Candidate (TBC)

Prof Sallie Pearson – UNSW Sydney

Prof Jerry Greenfield - UNSW Sydney

Prof David Henry - UNSW Sydney

Prof Ric Day - UNSW Sydney

Prof Nicole Pratt – University of South Australia

Research Question

What is the uptake, benefits and risk of harms of SGLT2i in routine care in Australia, across multiple clinical populations (ie., T2D, heart failure and CKD), older population groups and people with multimorbidity?

Specifically, we want to:

1: Quantify whole of population utilisation of SGLT2i;

2: Estimate the benefits of increased uptake of SGLT2i; and

3: Identify safety signals and estimate the risk of harms due to increased use of SGLT2i

Data Sources

The Medicines Intelligence Data Platform (MIDP)

Policy Implications

This research will form a good model for future work in this area while building capacity in big data analytics. 

It will also demonstrate the value of our novel linked data platform which provides the comprehensive information needed to inform and evaluate equitable access to medicines. 

Findings from this research on characteristics associated with gaps in access will support the development of prevention and treatment programs appropriately tailored to ensure equitable outcomes and prioritize people who are not yet accessing life-saving medicines. It will generate evidence required to increase confidence in prescribing those medicines in routine care, to inform policies governing the access to these medicines and scaling up their use to realise the full potential of these medicines in reducing hospitalisations, kidney failure and deaths at the population-level

End Users

Next users / Implementers:

• Clinicians and prescribers (general practitioners, endocrinologists, cardiologists, nephrologists)
• Clinical societies (Heart Foundation, Diabetes Australia)
• NSW Health
• Regulators (e.g., Therapeutic Goods Administration, Drug Utilisation Sub Committee)
• Other researchers

Beneficiaries:

• Patients/Carers of people living with type II diabetes, heart failure or chronic kidney disease
• Healthcare providers
• State and national policymakers

Impact

Stay tuned

This section will be updated throughout the project. Please return in the future to see the impact from this project.