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

Title: Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register
Authors: Succurro E.; Novella A.; Nobili A.; Giofre F.; Arturi F.; Sciacqua A.; Andreozzi F.; Pietrangelo A.; Sesti G.; REPOSI Investigators; Damanti S.
Contributors: Succurro, E.; Novella, A.; Nobili, A.; Giofre, F.; Arturi, F.; Sciacqua, A.; Andreozzi, F.; Pietrangelo, A.; Sesti, G.; Reposi, Investigator; Damanti, S.
Publisher Information: Springer Science and Business Media Deutschland GmbH
Publication Year: 2023
Subject Terms: Anti-diabetes drugs; Diabetes; Elderly people; Hospitalized patients; Prescription appropriateness
Description: 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 ≥ 65years 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.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/36964858; info:eu-repo/semantics/altIdentifier/wos/WOS:000958739700002; volume:18; issue:4; firstpage:1049; lastpage:1063; numberofpages:15; journal:INTERNAL AND EMERGENCY MEDICINE; https://hdl.handle.net/20.500.11768/166864
DOI: 10.1007/s11739-023-03254-3
Availability: https://hdl.handle.net/20.500.11768/166864; https://doi.org/10.1007/s11739-023-03254-3; https://link.springer.com/article/10.1007/s11739-023-03254-3
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.CEA5846A
Database: BASE