A Cross-Sectional Retrospective Study Assessing Potentially Inappropriate Medications for Elderly Diabetic Patients in a Tertiary Care Hospital in Saudi Arabia.

IF 2.7 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES Risk Management and Healthcare Policy Pub Date : 2024-12-19 eCollection Date: 2024-01-01 DOI:10.2147/RMHP.S484334

Haifa A Fadil, Ziyad S Alrehaili, Khaled M Alharbi, Abdulaziz F Almuzaini, Raed Hamed Alharbi, Hindi S Alharbi, Hossein M Elbadawy, Yaser M Alahmadi

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Abstract

Background: The aging global population presents challenges in medication management, particularly among diabetic elderly patients vulnerable to potentially inappropriate medications (PIM). PIM can lead to adverse outcomes like hypoglycemia, falls, cognitive decline, and hospitalizations, affecting quality of life and survival. This study aimed to assess PIM prevalence among diabetic elderly patients in a tertiary care hospital in Saudi Arabia, using the American Geriatrics Society 2023 Updated Beers Criteria.

Methods: A cross-sectional retrospective study was conducted among 480 diabetic adults aged 60 years or older at a tertiary care hospital over 3 months. Data, including demographics, comorbidities, and medication use, were extracted from Electronic Health Records. 2023 AGS Updated Beers Criteria® was followed.

Results: The median age was 66 years with a male predominance (62.7%). Peripheral vascular disease (42.7%) and prior myocardial infarction (22.7%) were prevalent comorbidities. Inappropriate insulin use was observed in 17.7% of insulin users, mainly short-acting insulin without basal/long-acting insulin. Approximately 39.2% of patients were prescribed antidiabetic drugs deemed inappropriate by Beers Criteria, with Gliclazide being the most common (35.6%). Despite potential drug-disease interactions, such as urogenital infections, half of the patients received cautioned drugs, while only 4.2% experienced such infections.

Conclusion: The study highlights the prevalence of PIMs among diabetic elderly patients in Madinah, Saudi Arabia. Adherence to Beers Criteria guidelines is crucial to optimize therapy for this population. Age and congestive heart failure were significant predictors of PIM use.

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一项评估沙特阿拉伯三级医院老年糖尿病患者可能不适当用药的横断面回顾性研究。

背景：全球人口老龄化对药物管理提出了挑战，特别是在糖尿病老年患者中，他们容易受到潜在不适当药物（PIM）的影响。PIM可导致低血糖、跌倒、认知能力下降和住院等不良后果，影响生活质量和生存。本研究旨在评估沙特阿拉伯三级医院糖尿病老年患者PIM的患病率，采用美国老年医学会2023年更新的比尔斯标准。方法：横断面回顾性研究480例60岁以上糖尿病成人在三级医院超过3个月。数据，包括人口统计、合并症和药物使用，从电子健康记录中提取。遵循2023 AGS更新的Beers标准®。结果：中位年龄66岁，男性为主（62.7%）。周围血管疾病（42.7%）和既往心肌梗死（22.7%）是常见的合并症。17.7%的胰岛素使用者发现胰岛素使用不当，主要是短效胰岛素，没有基础/长效胰岛素。约39.2%的患者被比尔斯标准认为不合适的降糖药处方，其中格列齐特是最常见的（35.6%）。尽管存在潜在的药物-疾病相互作用，如泌尿生殖系统感染，但一半的患者接受了谨慎的药物治疗，而只有4.2%的患者经历了此类感染。结论：本研究强调了沙特阿拉伯麦地那市老年糖尿病患者中pim的患病率。遵守比尔斯标准指南对于优化这一人群的治疗至关重要。年龄和充血性心力衰竭是PIM使用的重要预测因素。

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来源期刊

Risk Management and Healthcare Policy Medicine-Public Health, Environmental and Occupational Health

CiteScore

6.20

自引率

2.90%

发文量

242

审稿时长

16 weeks

期刊介绍： Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include: Public and community health Policy and law Preventative and predictive healthcare Risk and hazard management Epidemiology, detection and screening Lifestyle and diet modification Vaccination and disease transmission/modification programs Health and safety and occupational health Healthcare services provision Health literacy and education Advertising and promotion of health issues Health economic evaluations and resource management Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.