ADHERENCE OF CHRONIC KIDNEY DISEASE PATIENTS TO SODIUM-GLUCOSE COTRANSPORTER-2 INHIBITOR (SGLT2I) DURING RAMADAN PERIOD
Ms Fei Yee Lee1, Dr Kung Ung Tiong2, Dr Hajar Ahmad Rosdi1, Dr Hui Nee Liew2, Dr Gabriel Kin Wei Kwong2, Dr Siti Hafizah Mohammad Ismail2, Dr Suryati Yakob1,2,3
1Clinical Research Centre, Selayang Hospital, Ministry Of Health Malaysia, Batu Caves,, Malaysia, 2Nephrology Department, Selayang Hospital, Ministry Of Health Malaysia, Batu Caves,, Malaysia, 3Nephrology Department, Kuala Lumpur Hospital, Ministry Of Health Malaysia, , Malaysia
Aim: To describe the adherence of chronic kidney disease (CKD) patients to sodium-glucose cotransporter-2 inhibitor (SGLT2i) during the Ramadan period.
Background: The use of SGLT2i has been proven to delay progression of CKD. During Ramadan month, Muslims fast from dawn till sunset, leading to significant changes in meal schedule and nutrient intake. The tolerability and adherence to SGLT2i during Ramadan period are unknown, considering the possibility of developing ketoacidosis with SGLT2i use in fasting state.
Methods: This cross-sectional study was conducted in a tertiary hospital at Malaysia, which recruited CKD patients receiving SGLT2i for ≥3 months and attended CKD clinic follow-up during 2024 Ramadan. Baseline and current estimated glomerular filtration rate (eGFR) was calculated via CKD-EPI equation. Patients with unknown date of SGLT2i initiation were excluded.
Demographic data, clinical information, laboratory data and medication history were collected from medical records. Adherence to SGLT2i was assessed with Malaysia Medication Adherence Assessment Tool (MyMAAT), points ≤53 are classified as poor adherence. Statistical analysis was performed using SPSS Version 23.
Results: This study included 56 patients who fulfilled inclusion criteria, predominated by male (n=36, 35.7%), stage 4 CKD (n=18, 32.1%) with the mean age of 55.8±15.6 years. Mean eGFR during Ramadan period (42.7±23.1ml/min/1.73m²) was significantly lower than baseline (51.1±25.2 ml/min/1.73m², p<0.001). One-quarter (n=14, 25.0%) of patients were non-adherent to SGLT2i, with no significant difference by fasting status (non-fasting: 28.6% vs fasting: 22.9%, p=0.633) mainly attributed by forgetfulness (n=12, 85.7%).
Conclusions: This analysis reveals that 25% of CKD patients were non-adherent to SGLT2i during Ramadan period irrespective of fasting status. A concerted effort is crucial to identify and mitigate factors contributing to SGLT2i non-adherence.
Biography:
Fei Yee Lee is a research pharmacist in Institute of Clinical Research, Ministry of Health Malaysia. She has embarked on a less travelled journey in her country as a research pharmacist. While being involved in direct patient care through involvement in Nephrology clinical trials, she is also involved in investigator-initiated researches. She received several accolades in local and international levels for research papers presented. Other than Nephrology, her research interests include medication safety, pharmacovigilance and others.