Cambios en la prescripción omitida en el sistema endocrino en ancianos diabéticos de una zona de salud

Abstract

ObjectiveTo determine the variation in the omitted prescriptions in a population of elderly diabetics in the period 2010-2014. Material and methodComparison of two cross-sectional descriptive studies (in 2010: 207 patients; and 221 patients in 2014) using the clinical history records of diabetic patients ≥65 years. An assessment was made of the changes in laboratory parameters, use of drugs for diabetes, and other cardiovascular risk factors, and specifically changes in START criteria (in Endocrine System). ResultsMetabolic control improved, especially in high values of HbA1C by at least 8% and 10%, respectively, and LDL cholesterol (P<.01). There were changes in the diabetic drugs (decrease in sulphonylureas and increase in dipeptidyl peptidase-4 inhibitors (DPP-4s), in single and combined therapy). There were improvements in the use of antiplatelet drugs if there was high blood pressure (P<.001) or dyslipidaemia (P<.05). There were non-significant improvements in the use of metformin or statins, as well as in the use of ACE/ARAII inhibitors in patients with renal illness. The number of drugs for the treatment of diabetes and associated cardiovascular risk factors has increased from 4.02±1.71 to 4.57±1.81 (p<.01) in 2010 and 2014, respectively), as well as an increase in the percentage of patients on multiple therapy (≥5 drugs) in the treatment of diabetes and associated cardiovascular risk factors, from 40.1% in 2010 to 56.8% in 2014 (P<.001). ConclusionsIn the period of 2010-2014, metabolic control has improved and the number of omitted prescriptions has decreased in the Endocrine System (START criteria) in elderly diabetics, although it is still improvable. Consequently, there is a significant increase of multiple drug therapy.