{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T03:29:42Z","timestamp":1786332582395,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Am Coll Clin Pharm"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite strong evidence supporting cardiovascular and kidney benefits of sodium\u2010glucose co\u2010transporter\u20102 inhibitors (SGLT2i) and glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101 RA) in patients with type 2 diabetes, prescribing rates remain suboptimal. The aim of this study was to assess clinicians' knowledge and comfort prescribing SGLT2i and GLP\u20101 RA in clinical practice and factors influencing prescribing of these agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multi\u2010methods study used questionnaires to assess self\u2010reported knowledge and comfort prescribing SGLT2i and GLP\u20101 RA, and semi\u2010structured interviews based on the Consolidated Framework for Implementation Research (CFIR) to assess factors affecting prescribing decisions among 21 clinicians (12 primary care physicians, 4 pharmacists, 5 nurse practitioners) at a large community\u2010based health system in Virginia. Questionnaire results were analyzed using descriptive statistics, and interviews used a two\u2010phase analytic approach combining inductive and deductive coding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinicians self\u2010reported high knowledge (7.9\/10) and comfort (8.1 and 8.4\/10) prescribing SGLT2i and GLP\u20101 RA but identified multiple implementation barriers. The most significant barriers were insurance coverage and out\u2010of\u2010pocket costs, with prior authorization requirements delaying therapy initiation. Medicare beneficiaries faced particularly challenging access due to coverage gaps and ineligibility for manufacturer assistance programs. Organizational factors, including high workload, limited appointment time, and the absence of automated patient identification systems, hindered consistent prescribing. Medication burden, side effects, and aversion to injectable medications emerged as patient\u2010related barriers. Facilitators included strong clinical evidence supporting these agents, organizational culture supportive of innovation, and access to pharmacist support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite high self\u2010reported knowledge and comfort prescribing SGLT2i and GLP\u20101 RA, clinicians identified barriers to their use in clinical practice at the patient, clinician, organizational, and medication access levels. Future work should identify the best implementation strategies to address these barriers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jac5.70263","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:46:47Z","timestamp":1785296807000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Contextual Factors Affecting\n                    <scp>SGLT2<\/scp>\n                    Inhibitors and\n                    <scp>GLP<\/scp>\n                    \u20101 Receptor Agonists Prescribing in Primary Care: An Application of the Consolidated Framework for Implementation Research"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2708-7145","authenticated-orcid":false,"given":"Teresa M.","family":"Salgado","sequence":"first","affiliation":[{"name":"Department of Pharmacotherapy &amp; Outcomes Science Virginia Commonwealth University School of Pharmacy  Richmond Virginia USA"},{"name":"Center for Pharmacy Practice Innovation Virginia Commonwealth University School of Pharmacy  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7136-6273","authenticated-orcid":false,"given":"Rana","family":"Amayreh","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy &amp; Outcomes Science Virginia Commonwealth University School of Pharmacy  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7424-2799","authenticated-orcid":false,"given":"Mona","family":"Alshahawey","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy &amp; Outcomes Science Virginia Commonwealth University School of Pharmacy  Richmond Virginia USA"},{"name":"Department of Clinical Pharmacy, Faculty of Pharmacy Ain Shams University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerri T.","family":"Musselman","sequence":"additional","affiliation":[{"name":"CKB Health Consulting LLC  Midlothian Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tonya M.","family":"Buffington","sequence":"additional","affiliation":[{"name":"Bon Secours Mercy Health  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haroon","family":"Hyder","sequence":"additional","affiliation":[{"name":"Bon Secours Mercy Health  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0080-4047","authenticated-orcid":false,"given":"Resa M.","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Barnett College of Public Health Temple University  Philadelphia Pennsylvania USA"},{"name":"Fox Chase Cancer Center, Temple Health Temple University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7560-9521","authenticated-orcid":false,"given":"Dave L.","family":"Dixon","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy &amp; Outcomes Science Virginia Commonwealth University School of Pharmacy  Richmond Virginia USA"},{"name":"Center for Pharmacy Practice Innovation Virginia Commonwealth University School of Pharmacy  Richmond Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1600827"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603827"},{"issue":"18","key":"e_1_2_11_4_1","first-page":"1801","article-title":"Empagliflozin and Progression of Kidney Disease in Type 2 Diabetes","volume":"375","author":"Wanner C.","year":"2016","journal-title":"New England Journal of Medicine"},{"issue":"22","key":"e_1_2_11_5_1","first-page":"2196","article-title":"Liraglutide and Renal Outcomes in Type 2 Diabetes","volume":"377","author":"Imprialos K. 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