Consensus on ONgoing Educational Practices to Improve SGLT2i Adherence in India: Consensus ONE SGLT2i Adherence Group

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) directly inhibit the SGLT2protein in kidney proximal tubules, leading to increased glucose excretion. Medicationadherence ensures individuals receive intended therapeutic effects, optimizing overalltreatment effectiveness. The primary objective of this consensus study was to pinpoint theprevalent adverse effects associated with SGLT2i and establish optimal clinical practices foreducating patients during the initiation of therapy. Methods: A diverse panel of experts,consisting of 158 clinicians specializing in diabetes care across India, were invited to engagein a Delphi discussion following an initial online survey conducted via email. Throughoutthe process, panelists were actively encouraged to offer feedback on the compiled responses,allowing for adjustments in their perspectives. Subsequently, the outcomes of each meetingwere consolidated to form final recommendations. Results: About 88.24% of participantsidentified initiating SGLT2i for type 2 diabetes with atherosclerotic cardiovascular disease,heart failure or chronic kidney disease. Considerations for prescribing include eGFR <25 mL/min/1.73 m² (66.46%), a history of urinary tract infection (65.82%), and prior genital mycoticinfections. Most (53.71%) preferred tips in prescriptions, and 63.92% consistently educatedpatients about SGLT2i use, with 64.15% strongly agreeing it alleviates clinical inertia; 68.35%strongly supported regional language education, and 79.11% endorsed QR-based patienteducation in smart prescriptions (Rx). Conclusion: Educating patients in regional languages,leveraging technology and providing printed literature are crucial strategies for overcomingclinical inertia and enhancing medication adherence.