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.; Guidotti, Luca; 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. - 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
Mazzetti M.;Luca G.;Carbone M.;Mancuso G.;Ratti F.;Catalano A.;Vignali A.;Monaco L.;Damanti S.;
2023-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
