Evaluation of metformin use in non-critically hospitalized patients at a single tertiary hospital in Saudi Arabia: A cross-sectional study

The aim of this study was to assess the safety of metformin use in non-critically hospitalized patients. A cross-sectional study was performed at a single tertiary hospital in Saudi Arabia between January 2019 and June 2019. Patients aged >18 years with a confirmed diagnosis of type 2 diabetes who were taking metformin prior to admission were included. The primary outcome was the appropriateness of metformin use in non-critically hospitalized patients. A total of 251 patients were included in this study. Metformin was appropriate in 96 patients (38.2%). There were 14 (5.6%) incidences of absolute contra-indications and 141 (56.1%) incidences of precautions. Non-Saudi patients were about 1.856 times more likely to receive an inappropriate metformin dosage regimen compared to Saudi patients (AOR= 1.856; P= 0.022, 95% CI= 1.093, 3.151). Additionally, patients with chronic kidney disease (stage 3A) were approximately 2 times less likely to receive an inappropriate metformin dosage regimen than patients on stage 5 (AOR= 0.482; P= 0.035, 95% CI= 0.243, 0.835). This study highlighted a high rate of inappropriate metformin use in non-critically hospitalized patients. However, patients who were non-Saudi and at an advanced stage of chronic kidney disease were more likely to receive an inappropriate metformin dosage regimen.