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

Authors :
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
Source :
Internal & Emergency Medicine; Jun2023, Vol. 18 Issue 4, p1049-1063, 15p
Publication Year :
2023

Abstract

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]

Details

Language :
English
ISSN :
18280447
Volume :
18
Issue :
4
Database :
Complementary Index
Journal :
Internal & Emergency Medicine
Publication Type :
Academic Journal
Accession number :
164747189
Full Text :
https://doi.org/10.1007/s11739-023-03254-3