Abstract
In France, around 5% of the general population are taking drug treatments for diabetes mellitus (mainly type 2 diabetes mellitus, T2DM). Although the management of T2DM has become more complex, most of these patients are managed by their general practitioner and not a diabetologist for their antidiabetics treatments; this increases the risk of potentially inappropriate prescriptions (PIPs) of hypoglycaemic agents (HAs). Inappropriate prescribing can be assessed by approaches that are implicit (expert judgement based) or explicit (criterion based). In a mixed, multistep process, we first systematically reviewed the published definitions of PIPs for HAs in patients with T2DM. The results will be used to create the first list of explicit definitions. Next, we will complete the definitions identified in the systematic review by conducting a qualitative study with two focus groups of experts in the prescription of HAs. Lastly, a Delphi survey will then be used to build consensus among participants; the results will be validated in consensus meetings. We developed a method for determining explicit definitions of PIPs for HAs in patients with T2DM. The resulting explicit definitions could be easily integrated into computerised decision support tools for the automated detection of PIPs.
Highlights
In France, in 2017, 5% of the general population were taking drug treatments for diabetes mellitus (DM) [1]
Around 90% of these individuals have type 2 diabetes mellitus (T2DM), which is characterised by insulin resistance [2]
The increasingly complex management of T2DM can be challenging for most physicians and might, increase the risk of potentially inappropriate prescriptions (PIPs) of hypoglycaemic agents (HAs) among patients with T2DM [5,6,7]
Summary
In France, in 2017, 5% of the general population (more than 3.3 million people) were taking drug treatments for diabetes mellitus (DM) [1]. Inappropriate prescribing is defined as the potential use of medicine with more risks than benefits— when safer alternatives are available. The explicit approach is based on prescription data and does not require expert assessment (i.e., can be directly implemented for use in medical informatics) [13,14]. In this regard, inappropriate prescribing of HAs to patients with T2DM has mainly been reported based on an implicit approach [15,16,17,18]. To the best of our knowledge, explicit definitions of PIPs of HAs in patients with T2DM have not previously been listed
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