Association of British Clinical Diabetologists

Dapagliflozin Nationwide Audit

 
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Above - dapagliflozin selectively inhibits SGLT2 in the renal proximal tubule leading to increased urinary excretion of excess glucose. In clinical trials this translated into reduction in HbA1c and weight - click to enlarge

 

Above: It does seem in the clinical trials that whilst the effect of sulphonylureas wanes with time, the effect of dapagliflozin is sustained. But will this also be the finding in real clinical use?  click to enlarge

 

Above: Compared to the weight gain associated with sulphonylurea use, the weight loss associated with dapagliflozin is an attractive feature of the medication in the clinical trials. But is this also what will be found in real clinical use - click to enlarge

 

Above: In the clinical trials genital infections occurred but did not usually lead to cessation of therapy. There was no excess of severe urinary tract infections. It will be important to establish whether the agent is as safe in real clinical practice - click to enlarge

ABCD nationwide dapagliflozin audit on N3

About the ABCD nationwide dapagliflozin audit
This audit is particularly important with dapagliflozin being the first of a new class of drugs for diabetes, the SGLT2 inhibitors. As with the ABCD GLP1-receptor agonist audits (exenatide, liraglutide and exenatide QW) it may be that patients being treated with the new class in real clinical practice will be different from those in clinical trials and outcomes may also be different both in terms of safety and efficacy. As with the exenatide QW audit, the great step forward for this audit is that it is being hosted on N3 - the latest version of NHSnet. Access the on-line tool for the audit does require the user to be on N3 ie in an NHS hospital, GP surgery etc. The audit launched in September 2014 and has a number of objectives. The first data analysis from the audit was undertaken for the ABCD autumn meeting on November 6, 2015. Click here to see the output from the audit as it evolves. The names of all the contributors will be found in the presentation slides and in the published papers.

The new web-based audit tool on N3
The new audit tool is based on the exenatide QW audit tool. It is easy to use. Being on N3 it has optimum security for patient identifiable data with regard to your own patients, but anonymises the data when it is utilised in the national audit. There are some special features with regard to the data export both for your own local analysis and for the nationwide analysis. The export now allows you to choose which data to download for analysis as well as providing all data. It also allows you to choose to download the data aggregated to 2 monthly, 3 monthly, 4 monthly or 6 monthly time points.  The tool has the facility to detect data from the same patient entered in two sites (eg hospital and primary care) and to merge the data when exported - see centres and sites below.

Structure of the audit centres and sites
For this audit the concept of centres and sites is utilised in the same way as in the exenatide QW audit. Typically a centre might be an NHS Trust. Sites might be hospitals associated with that Trust, and/or health centres or GP surgeries in the local vicinity. If set up in this structure, designated leaders of the local audit would be given access to download the anonymised data of all the patients associated with the centre for more powerful local analysis of data involving higher numbers. Findings so made through such local analysis could be put forward for further testing on the full national dataset.

Collect data on-line or via paper forms
The new N3 on-line audit tool is so easy to use that live data entry in clinic is a real option to be considered. Otherwise to facilitate data collection during clinics there are two paper forms which exactly match the data that can be entered into the audit tool. You can download and print these forms locally or
order pre-printed data entry forms.

To download the forms to printout for use, use the following links:

Download first visit data entry form
Download follow up visit data entry form

Non ABCD members
Non ABCD members are welcome to take part in the audit and will be given access to the on-line audit tool when they register for the audit.

Register to take part in the audit and access to the on-line tool
To register for the audit and be given access to the on-line tool on the ABCD website on N3 click here.

Northern Ireland and Worldwide
As Northern Ireland is not on N3, a non N3 version of the tool has been developed which can allow any country in the world to enrol at no cost and utilise the facilities. Any country, and centres in the country, may collect and analyse their own data which will then automatically become part of worldwide audit. For more information click here.

Papers, abstracts, presentations, posters and webcasts emanating from the audit
Click here to see the output from the audit as it evolves. The names of all the contributors will be found in the presentation slides and in the published papers.

Further information
Further enquiries may be made to the ABCD nationwide audits database administrator of the project, Melissa Cull

   Register for the dapagliflozin audit: UK

Register for the dapagliflozin audit: Northern Ireland and non-UK

Register simultaneously for ALL 3 SGLT2 audits: canagliflozin, dapagliflozin and empagliflozin

Access the on-line tool
(UK: you need to be on N3)

Access the worldwide on-line tool
(Northern Ireland and non-UK)

Dapagliflozin audit objectives

Order preprinted data entry forms

Download first visit data entry form

Download follow up visit data entry form

Papers, abstracts, presentations, posters from the audit

Further information- contact us

Main ABCD homepage

     

The ABCD nationwide dapagliflozin audit is an independent audit supported by an unrestricted grant from Astra Zeneca

Working to support high quality diabetes care in the UK