Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting : evidence from the REPOSI Register
© 2023. The Author(s)..
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.
| Errataetall: |
ErratumIn: Intern Emerg Med. 2023 Aug;18(5):1611. - PMID 37535294 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
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| Enthalten in: |
Internal and emergency medicine - 18(2023), 4 vom: 25. Juni, Seite 1049-1063 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Succurro, Elena [VerfasserIn] |
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| Links: |
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| Themen: |
9100L32L2N |
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| Anmerkungen: |
Date Completed 10.07.2023 Date Revised 17.11.2023 published: Print-Electronic ErratumIn: Intern Emerg Med. 2023 Aug;18(5):1611. - PMID 37535294 Citation Status MEDLINE |
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| doi: |
10.1007/s11739-023-03254-3 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354699415 |
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| 500 | |a ErratumIn: Intern Emerg Med. 2023 Aug;18(5):1611. - PMID 37535294 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Anti-diabetes drugs | |
| 650 | 4 | |a Diabetes | |
| 650 | 4 | |a Elderly people | |
| 650 | 4 | |a Hospitalized patients | |
| 650 | 4 | |a Prescription appropriateness | |
| 650 | 7 | |a Metformin |2 NLM | |
| 650 | 7 | |a 9100L32L2N |2 NLM | |
| 700 | 1 | |a Novella, Alessio |e verfasserin |4 aut | |
| 700 | 1 | |a Nobili, Alessandro |e verfasserin |4 aut | |
| 700 | 1 | |a Giofrè, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Arturi, Franco |e verfasserin |4 aut | |
| 700 | 1 | |a Sciacqua, Angela |e verfasserin |4 aut | |
| 700 | 1 | |a Andreozzi, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Pietrangelo, Antonello |e verfasserin |4 aut | |
| 700 | 1 | |a Sesti, Giorgio |e verfasserin |4 aut | |
| 700 | 0 | |a REPOSI Investigators |e verfasserin |4 aut | |
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| 700 | 1 | |a Marengoni, Alessandra |e investigator |4 oth | |
| 700 | 1 | |a Tettamanti, Mauro |e investigator |4 oth | |
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| 700 | 1 | |a Franchi, Carlotta |e investigator |4 oth | |
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| 700 | 1 | |a Tettamanti, Mauro |e investigator |4 oth | |
| 700 | 1 | |a Miglio, Gabriella |e investigator |4 oth | |
| 700 | 1 | |a Tettamanti, Mauro |e investigator |4 oth | |
| 700 | 1 | |a Ardoino, Ilaria |e investigator |4 oth | |
| 700 | 1 | |a Cantiero, Silvia |e investigator |4 oth | |
| 700 | 1 | |a Prisco, Domenico |e investigator |4 oth | |
| 700 | 1 | |a Silvestri, Elena |e investigator |4 oth | |
| 700 | 1 | |a Emmi, Giacomo |e investigator |4 oth | |
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| 700 | 1 | |a Pirro, Matteo |e investigator |4 oth | |
| 700 | 1 | |a Lupattelli, Graziana |e investigator |4 oth | |
| 700 | 1 | |a Bianconi, Vanessa |e investigator |4 oth | |
| 700 | 1 | |a Alcidi, Riccardo |e investigator |4 oth | |
| 700 | 1 | |a Giotta, Alessia |e investigator |4 oth | |
| 700 | 1 | |a Mannarino, Massimo R |e investigator |4 oth | |
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| 700 | 1 | |a Busti, Fabiana |e investigator |4 oth | |
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| 700 | 1 | |a Beneduce, Vincenza |e investigator |4 oth | |
| 700 | 1 | |a Cacioppo, Federica |e investigator |4 oth | |
| 700 | 1 | |a Corrao, Salvatore |e investigator |4 oth | |
| 700 | 1 | |a Natoli, Giuseppe |e investigator |4 oth | |
| 700 | 1 | |a Mularo, Salvatore |e investigator |4 oth | |
| 700 | 1 | |a Raspanti, Massimo |e investigator |4 oth | |
| 700 | 1 | |a Argano, Christiano |e investigator |4 oth | |
| 700 | 1 | |a Cavallaro, Federica |e investigator |4 oth | |
| 700 | 1 | |a Zoli, Marco |e investigator |4 oth | |
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| 700 | 1 | |a Serafini, Giovanni |e investigator |4 oth | |
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| 700 | 1 | |a Scaramellini, Natalia |e investigator |4 oth | |
| 700 | 1 | |a Stefano, Valeria |e investigator |4 oth | |
| 700 | 1 | |a Leoni, Simona |e investigator |4 oth | |
| 700 | 1 | |a Seghezzi, Sonia |e investigator |4 oth | |
| 700 | 1 | |a Di Mauro, Alessandra Danuto |e investigator |4 oth | |
| 700 | 1 | |a Maira, Diletta |e investigator |4 oth | |
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| 700 | 1 | |a Pitotti, Lavinia |e investigator |4 oth | |
| 700 | 1 | |a Antoci, Valentina |e investigator |4 oth | |
| 700 | 1 | |a Cambiè, Ginevra |e investigator |4 oth | |
| 700 | 1 | |a Pitotti, Lavinia |e investigator |4 oth | |
| 700 | 1 | |a Antoci, Valentina |e investigator |4 oth | |
| 700 | 1 | |a Pontremoli, Roberto |e investigator |4 oth | |
| 700 | 1 | |a Beccati, Valentina |e investigator |4 oth | |
| 700 | 1 | |a Nobili, Giulia |e investigator |4 oth | |
| 700 | 1 | |a Leoncini, Giovanna |e investigator |4 oth | |
| 700 | 1 | |a Alberto, Jacopo |e investigator |4 oth | |
| 700 | 1 | |a Cattaneo, Federico |e investigator |4 oth | |
| 700 | 1 | |a Anastasio, Luigi |e investigator |4 oth | |
| 700 | 1 | |a Sofia, Lucia |e investigator |4 oth | |
| 700 | 1 | |a Carbone, Maria |e investigator |4 oth | |
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| 700 | 1 | |a Rossi, Ilaria |e investigator |4 oth | |
| 700 | 1 | |a Valeriani, Emanuele |e investigator |4 oth | |
| 700 | 1 | |a D'Ardes, Damiano |e investigator |4 oth | |
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