Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register.

Autor: Succurro, Elena, Novella, Alessio, Nobili, Alessandro, Giofrè, Federica, Arturi, Franco, Sciacqua, Angela, Andreozzi, Francesco, Pietrangelo, Antonello, Sesti, Giorgio, Perticone, Francesco, Violi, Francesco, Corrao, Salvatore, Marengoni, Alessandra, Tettamanti, Mauro, Pasina, Luca, Franchi, Carlotta, Miglio, Gabriella, Ardoino, Ilaria, Cantiero, Silvia, Prisco, Domenico
Zdroj: Internal & Emergency Medicine; Jun2023, Vol. 18 Issue 4, p1049-1063, 15p
Abstrakt: Diabetes is an increasing global health burden with the highest prevalence (24.0%) observed in elderly people. Older diabetic adults have a greater risk of hospitalization and several geriatric syndromes than older nondiabetic adults. For these conditions, special care is required in prescribing therapies including anti- diabetes drugs. Aim of this study was to evaluate the appropriateness and the adherence to safety recommendations in the prescriptions of glucose-lowering drugs in hospitalized elderly patients with diabetes. Data for this cross-sectional study were obtained from the REgistro POliterapie–Società Italiana Medicina Interna (REPOSI) that collected clinical information on patients aged ≥ 65 years acutely admitted to Italian internal medicine and geriatric non-intensive care units (ICU) from 2010 up to 2019. Prescription appropriateness was assessed according to the 2019 AGS Beers Criteria and anti-diabetes drug data sheets.Among 5349 patients, 1624 (30.3%) had diagnosis of type 2 diabetes. At admission, 37.7% of diabetic patients received treatment with metformin, 37.3% insulin therapy, 16.4% sulfonylureas, and 11.4% glinides. Surprisingly, only 3.1% of diabetic patients were treated with new classes of anti- diabetes drugs. According to prescription criteria, at admission 15.4% of patients treated with metformin and 2.6% with sulfonylureas received inappropriately these treatments. At discharge, the inappropriateness of metformin therapy decreased (10.2%, P < 0.0001). According to Beers criteria, the inappropriate prescriptions of sulfonylureas raised to 29% both at admission and at discharge. This study shows a poor adherence to current guidelines on diabetes management in hospitalized elderly people with a high prevalence of inappropriate use of sulfonylureas according to the Beers criteria. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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