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4CPS-226 Pharmaceutical intervention on the adequacy of the indication of semaglutide in diabetes mellitus 2
  1. CM Dominguez Santana,
  2. ME Blanco Rivas,
  3. V Vazquez Vela,
  4. EJ Alegre Del Rey,
  5. JM Borrero Rubio
  1. Hospital Universitario Puerto Real, Hospital Pharmacy, Puerto Real, Spain


Background and Importance Semaglutide is a GLP-1 analogue approved for the treatment of adults with poorly controlled type 2 diabetes mellitus (DMII). It has been shown to reduce blood glucose levels and the risk of health complications. It also produces weight loss, an effect considered beneficial in this type of patient. This has led to inconsistent prescribing, and it has even been used to reduce weight in obese non-diabetic patients. As a consequence of the increase in inappropriate use, in March 2023 the Spanish Agency for Medicines and Health Products issued a shortage alert.

Aim and Objectives Implementation of a strategy to review the suitability of semaglutide to its therapeutic indication and intervention in inappropriate prescriptions.

Material and Methods Prospective descriptive study including all patients on active treatment with semaglutide. An intervention strategy was implemented by reviewing all medical prescriptions, stratifying patients by hospital services, and drawing up lists of patients who did not comply with the authorised indications. In August 2023, meetings were held with the doctor in charge of each department to communicate the need for review and the suspension of treatment of patients who did not comply with the indication.

Results Sixty patients were reviewed, 62% male, with a median age of 54 years. Active semaglutide prescriptions by hospital services were as follows: 55% Endocrinology, 18.3% Cardiology, 16.7% Internal medicine, 3.3% Nephrology, 3.3% Mental health, 1.7% Dermatology and 1.7% Traumatology. 28.3% of patients had DMII, 46.7% did not and 25% had pre-DMII. Of the patients without DMII, 100% were obese. It was agreed to suspend treatment for all patients who did not comply with the indication.

Conclusion and Relevance The procedure has provided insight into the conditions under which semaglutide is being used. In the context of stock-outs, the suspension of semaglutide in patients with off-label use allowed access for poorly controlled diabetic patients. The adequacy review can be extrapolated to the abuse and/or misuse of any drug as part of the rational medicine use strategy.

Conflict of Interest No conflict of interest.

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