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

Medientyp: E-Artikel

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

Beteiligte: 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; Franchi, Carlotta; Tettamanti, Mauro; Miglio, Gabriella; Tettamanti, Mauro; Ardoino, Ilaria; Cantiero, Silvia; Prisco, Domenico; Silvestri, Elena; [...]

Erschienen: Springer Science and Business Media LLC, 2023

Sprache: Englisch

DOI: 10.1007/s11739-023-03254-3

ISSN: 1828-0447; 1970-9366

Schlagwörter: Emergency Medicine ; Internal Medicine

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Beschreibung: AbstractDiabetes 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.

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