{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T23:49:21Z","timestamp":1788997761444,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2016,6,30]],"date-time":"2016-06-30T00:00:00Z","timestamp":1467244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Metformin is the first\u2010line oral type 2 diabetes treatment. Despite an abundance of evidence, metformin is routinely underused. This study evaluated the rates of metformin use in an appropriate outpatient type 2 diabetes population and identified predictors of metformin use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A national cross\u2010sectional study was conducted using data from the National Ambulatory Medical Care Survey. Office visits involving patients aged 18\u201379 years with a diagnosis of type 2 diabetes were included, and visits involving patients with a diagnosis of chronic renal failure or heart failure were excluded. The primary outcome was metformin\u2010prescribing rate. Multivariate logistic regression identified variables associated with metformin prescribing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2348 patient visits were eligible for inclusion, representing 88,671,714 office visits nationally. Metformin was continued or initiated in 40.6% of these visits. The strongest independent predictors of metformin prescribing were insulin use (odds ratio [<jats:styled-content style=\"fixed-case\">OR]<\/jats:styled-content> 0.32; 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 0.21\u20130.47), presence of four or more chronic conditions (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.58; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.34\u20130.98), patients with Medicare insurance (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.57; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.39\u20130.83), visit with a surgical specialist (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.39; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.25\u20130.61) or a medical specialist (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 0.59; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.38\u20130.92), and Hispanic ethnicity (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.03; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.28\u20133.22).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Metformin\u2010prescribing rates are low, particularly in patients receiving insulin, with Medicare insurance, seen by medical or surgical specialists, or with four or more chronic conditions. The observed low rates of metformin use represent an important opportunity to improve the quality of care for patients with type 2 diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.1772","type":"journal-article","created":{"date-parts":[[2016,5,23]],"date-time":"2016-05-23T21:54:10Z","timestamp":1464040450000},"page":"715-722","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence and Predictors of Metformin Prescribing in Adults with Type 2 Diabetes Mellitus: A National Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"36","author":[{"given":"Mate M.","family":"Soric","sequence":"first","affiliation":[{"name":"Department of Pharmacy University Hospitals Geauga Medical Center Chardon Ohio"},{"name":"Department of Pharmacy Practice Northeast Ohio Medical University College of Pharmacy Rootstown Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Moorman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Akron General Medical Center Akron Ohio"},{"name":"Department of Pharmacy Practice Northeast Ohio Medical University College of Pharmacy Rootstown Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclyn A.","family":"Boyle","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Northeast Ohio Medical University College of Pharmacy Rootstown Ohio"},{"name":"Pharmacy Innovations, LLC Rootstown Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M.","family":"Dengler\u2010Crish","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Sciences Northeast Ohio Medical University College of Pharmacy Rootstown Ohio"},{"name":"Department of Anatomy and Neurobiology Northeast Ohio Medical University College of Medicine Rootstown Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,6,30]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"National Diabetes Statistics Report[article online]. 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