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.
Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register / Succurro E.; Novella A.; Nobili A.; Giofre F.; Arturi F.; Sciacqua A.; Andreozzi F.; Pietrangelo A.; Sesti G.; Perticone F.; Violi F.; Corrao S.; Marengoni A.; Tettamanti M.; Pasina L.; Franchi C.; Franchi C.; Miglio G.; Ardoino I.; Cantiero S.; Prisco D.; Silvestri E.; Emmi G.; Bettiol A.; Mattioli I.; Mazzetti M.; Biolo G.; Zanetti M.; Bartelloni G.; Zaccari M.; Chiuch M.; Martini I.; Pirro M.; Lupattelli G.; Bianconi V.; Alcidi R.; Giotta A.; Mannarino M.R.; Girelli D.; Busti F.; Marchi G.; Barbagallo M.; Dominguez L.; Beneduce V.; Cacioppo F.; Corrao S.; Natoli G.; Mularo S.; Raspanti M.; Argano C.; Cavallaro F.; Zoli M.; Orio G.; Magnolfi E.; Serafini G.; Brunori M.; Lazzari I.; Simili A.; Fabio G.; De Amicis M.M.; Luca G.; Scaramellini N.; Stefano V.; Leoni S.; Seghezzi S.; Di Mauro A.D.; Maira D.; Mancarella M.; Lucchi T.; Clerici M.; Leoni S.; Bonini G.; Conti F.; Prolo S.; Fabrizi M.; Martelengo M.; Vigani G.; Nicolini P.; Sabatino A.; Miceli E.; Pisati M.; Pitotti L.; Antoci V.; Cambie G.; Pitotti L.; Antoci V.; Pontremoli R.; Beccati V.; Nobili G.; Leoncini G.; Alberto J.; Cattaneo F.; Anastasio L.; Sofia L.; Carbone M.; Cipollone F.; Rossi I.; Valeriani E.; D'Ardes D.; Cipollone A.; Esposito L.; Sestili S.; Angelucci E.; Mancuso G.; Calipari D.; Bartone M.; Manetti R.; Sircana M.; Berria M.; Delitala A.; Muscaritoli M.; Molfino A.; Petrillo E.; Giorgi A.; Gracin C.; Imbimbo G.; Romanelli G.; Volpini A.; Lucente D.; Manzoni F.; Pirozzi A.; Zucchelli A.; Geneletti T.; Picardi A.; Bellelli G.; Corsi M.; Antonucci C.; Sidoli C.; Principato G.; Bonfanti A.; Szabo H.; Mazzola P.; Piazzoli A.; Corsi M.; Tassone B.; De Falco A.B.T.; Negro E.; Brenna M.; Trotta L.; Fabris F.; Bertozzi I.; Bogoni G.; Prandini T.; Ratti F.; Zurlo C.; Cerruti L.; Cosi E.; Reni E.; Manfredini R.; Boari B.; Giorgi A.; Tiseo R.; Savrie C.; Fabbian F.; Paolisso G.; Catalano C.; Meo I.; Sabba C.; Suppressa P.; De Vincenzo G.M.; Comitangelo A.; Amoruso E.; Custodero C.; Re G.; Barnaba I.; Schilardi A.; Fenoglio L.; Falcetta A.; D'Aniano S.; Tiraboschi S.; Cespiati A.; Oberti G.; Sigon G.; Cinque F.; Colavolpe L.; Curra J.; Alletto F.; Scaramellini N.; Leoni S.; Di Mauro A.D.; Benzoni G.; Peyvandi F.; Rossio R.; Colombo G.; Agosti P.; Pagliaro E.; Semproni E.; Canetta C.; Monzani V.; Savojardo V.; Ceriani G.; Folli C.; Tognin T.; Purrello F.; Pino A.; Piro S.; Rozzini R.; Falanga L.; Boffelli S.; Ferrandina C.; Mazzeo F.; Spazzini E.; Cono G.; Cesaroni G.; Perri L.; Guasti L.; Rotunno F.; Castiglioni L.; Maresca A.; Squizzato A.; Campiotti L.; Grossi A.; Dentali F.; Behnke V.; Perticone M.; Maio R.; Scozzafava A.; Condoleo V.; Clausi E.; Armentaro G.; Panza A.; Condoleo V.; Stanghellini V.; Ruggeri E.; Vecchio S.; Benzoni I.; Minisola S.; Colangelo L.; Cilli M.; Labbadia G.; Pepe J.; Castellino P.; Zanoli L.; Gaudio A.; Xourafa A.; Spichetti C.; Torre S.; Gennaro A.; Ballestrero A.; Ferrando F.; Gonella R.; Cerminara D.; Setti P.; Traversa C.; Scarsi C.; Famularo G.; Tarsitani P.; Morretti T.; Aglitti A.; Giacco S.; Firinu D.; Costanzo G.; Chessa S.; Montalto G.; Licata A.; Rizzo A.; Corica F.; Basile G.; Catalano A.; Bellone F.; Principato C.; Cocuzza A.; Mecocci P.; Ruggiero C.; Boccardi V.; Meschi T.; Ticinesi A.; Nouvenne A.; Pirisi M.; Sola D.; Bellan M.; Quadri R.; Larovere E.; Novelli M.; Simeone E.; Scurti R.; Tolloso F.; Tarquini R.; Valoriani A.; Dolenti S.; Vannini G.; Volpi R.; Bocchi P.; Vignali A.; Harari S.; Lonati C.; Napoli F.; Aiello I.; Salvatore T.; Monaco L.; Ricozzi C.; Coviello F.; Catalini C.; Pilotto A.; Indiano I.; Gandolfo F.; Gonella D.; Nuti R.; Valenti R.; Ruvio M.; Cappelli S.; Palazzuoli A.; Durante V.; Tirotta D.; Eusebi G.; Tresoldi M.; Bozzolo E.; Damanti S.; Porta M.; Gino M.; Pari B.; Pace E.. - In: INTERNAL AND EMERGENCY MEDICINE. - ISSN 1828-0447. - ELETTRONICO. - 18:4(2023), pp. 1049-1063. [10.1007/s11739-023-03254-3]
Prescription appropriateness of anti-diabetes drugs in elderly patients hospitalized in a clinical setting: evidence from the REPOSI Register
Pietrangelo A.;Sesti G.;Silvestri E.;Mattioli I.;Martini I.;Pirro M.;Orio G.;Magnolfi E.;Perticone M.;Stanghellini V.;Pepe J.;
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.File | Dimensione | Formato | |
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