Details

Autor(en) / Beteiligte

• Formiga, F.
• Vidal, X.
• Agustí, A.
• Chivite, D.
• Rosón, B.
• Barbé, J.
• López-Soto, A.
• Torres, O. H.
• Fernández-Moyano, A.
• García, J.
• Ramírez-Duque, N.
• San José, A.

Titel

Inappropriate prescribing in elderly people with diabetes admitted to hospital

Ist Teil von

• Diabetic medicine, 2016-05, Vol.33 (5), p.655-662

Ort / Verlag

England: Blackwell Publishing Ltd

Erscheinungsjahr

2016

Quelle

MEDLINE

Beschreibungen/Notizen

• Aims To assess inappropriate prescribing in older people with diabetes mellitus during the month prior to a hospitalization, using tools on potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) and comparing inappropriate prescribing in patients with without diabetes. Methods In an observational, prospective multicentric study, we assessed inappropriate prescribing in 672 patients aged 75 years and older during hospital admission. The Beers, Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tool to Alert Doctors to Right Treatment (START) criteria and Assessing Care of Vulnerable Elders (ACOVE‐3) medicine quality indicators were used. We analysed demographic and clinical factors associated with inappropriate prescribing. Results Of 672 patients, 249 (mean age 82.4 years, 62.9% female) had a diagnosis of diabetes mellitus. The mean number of prescribing drugs per patient with diabetes was 12.6 (4.5) vs. 9.4 (4.3) in patients without diabetes (P < 0.001). Of those patients with diabetes, 74.2% used 10 or more medications; 54.5% of patients with diabetes had at least one Beers‐listed PIM, 68.1% had at least one STOPP‐listed PIM, 64.6% had at least one START‐listed PPO and 62.8% had at least one ACOVE‐3‐listed PPO. Except for the Beers criteria, these prevalences were significantly higher in patients with diabetes than in those without. After excluding diabetes‐related items from these tools, only STOPP‐listed PIMs remained significantly higher among patients with diabetes (P = 0.04). Conclusions Polypharmacy is common among older patients with diabetes mellitus. Inappropriate prescribing is higher in older patients with diabetes, even when diabetes‐related treatment is excluded from the inappropriate prescribing evaluation. What's new? Older patients with diabetes mellitus show a higher degree of polypharmacy than those without diabetes, and three quarters of them take 10 or more drugs. Polypharmacy places them at high risk for inappropriate prescribing. Although polypharmacy seems difficult to avoid in such polypathological patients with diabetes, a careful review of indications, contraindications or drug–drug and drug–disease interactions should be mandatory to minimize the risk of inappropriate prescribing in these patients.