Knowledge, Attitude, and Practice of Metformin Extended-Release Tablets Among Clinicians in China: A Cross-Sectional Survey

Abstract

Background: Metformin extended-release (XR) is a once-daily alternative conventional immediate-release (IR) tablet for adults with type 2 diabetes. Aim: This study aimed to investigate the knowledge, attitude, and practice of the use of metformin XR tablets among clinicians. Methods: We conducted a cross-sectional online survey among endocrinologists, general practitioners, and internists, who are taking routine care of adults with type 2 diabetes in health institutes at all levels in Sichuan Province, China. We designed an online questionnaire including the demographic information, knowledge, attitude, and practice about metformin XR tablets. Results: We included 158 clinicians, 67.7% of whom were females and 63.9% were from tertiary hospitals. The median age was 39.6 years (ranging between 22 and 62 years). Only 8.2% of the clinicians correctly answered the knowledge questions, 82.3% and 62.0% of the responders assumed that metformin XR had superior efficacy and tolerability to the metformin IR, respectively. Only 46.8% of the clinicians prescribed the metformin XR based on the patient's preference for once daily frequency. Conclusion: The knowledge, attitude, and practice of metformin XR among Chinese clinicians need improving. Clinicians need credible information to support their clinical decision-making regarding metformin XR.

Keywords: adherence; clinician; knowledge—attitude—practice; metformin XR; metformin immediate release.

FIGURE 1

Responses to knowledge questions “the correct dosage range of metformin XR,” “the frequency of metformin XR,” “the proper timing of metformin XR administration.” Responses were compared between clinicians with <10 years of practice and with ≥10 years of practice, endocrinologists and non-endocrinologists, clinicians treated <50 cases and ≥50 cases with type 2 diabetes per month, clinicians practiced in non-tertiary hospital and tertiary hospital.

FIGURE 2

Responses to attitude questions “Comparing the metformin IR and XR, which is more effective?,” “Comparing the metformin IR and XR, which leads to more adverse effects?” “Which do you prefer to prescribe regarding efficacy and safety?” Responses were compared between clinicians with <10 years of practice and with ≥10 years of practice, endocrinologists and non-endocrinologists, clinicians treated <50 cases and ≥50 cases with type 2 diabetes per month, clinicians practiced in non-tertiary hospital and tertiary hospital.

FIGURE 3

Responses to practice question “What is the most important factor for prescribing metformin XR?” Responses were compared between clinicians with <10 years of practice and with ≥10 years of practice, endocrinologists and non-endocrinologists, clinicians treated <50 cases and ≥50 cases with type 2 diabetes per month, clinicians practiced in non-tertiary hospital and tertiary hospital.