Abstract
Background: Older patients with type 2 diabetes mellitus (T2DM) are at greater risk of receiving potentially inappropriate medications (PIM) during hospitalization which may result in adverse outcomes. Aim: To evaluate the extent of PIM use in the older population with T2DM during hospitalization in a tertiary care hospital in India. Methods: A cross-sectional study was carried out from August 2019 to January 2020 in a tertiary care teaching hospital among the older population (aged ≥ 65 years) hospitalized with T2DM. Medications prescribed during hospitalization were reviewed following Beers Criteria 2019 to identify the extent of polypharmacy and PIM use. Binary logistic regression was applied to determine the factors associated with PIM use. Results: The mean age of the 150 patients hospitalized with T2DM was 68.85 ± 5.51 years, most of whom were men (54.7%). The participants had at least four comorbidities and were receiving an average of nine medications per day; the median length of hospital stay was 8 days (interquartile range (IQR): 4–19 days). Overall, three quarters (74%) of the participants had at least one PIM prescribed during their hospitalization as per Beers Criteria. Significant factors associated with the use of PIM during hospitalization are patients taking a higher number of medications (odds ratio (OR): 7.85, 95% CI 1.49–41.10), lower creatinine clearance values (OR: 12.90, 95% CI 2.81–59.28) and female patients (OR: 2.29; 95% CI: 1.05–4.97). Conclusions: PIM use is frequently observed in older T2DM patients during hospitalization. Polypharmacy, reduced renal function and female gender are associated with higher PIM use. Engaging clinical pharmacists in evaluating medication appropriateness can improve the outcomes of older patients.
Highlights
Increased aging among the Indian population is considered as one of the driving forces behind the increased prevalence of type 2 diabetes mellitus (T2DM) in India [1,2]
We found that older women with T2DM were associated with a 129% higher chance than men of being exposed to potentially inappropriate medications (PIM) (OR: 2.29, 95% confidence interval (CI) 1.05–4.97, p = 0.036)
The data from previous studies using the 2015 version in older hospitalized patients with diabetes, reported 54.5% of patients to have at least one Beers-listed PIM in Spain [18], and 56% in Canada [24]. This high prevalence could be because older patients with T2DM have more comorbidities than the general population and they receive a high number of medications that increase their risk of PIM prescribing
Summary
Increased aging among the Indian population is considered as one of the driving forces behind the increased prevalence of type 2 diabetes mellitus (T2DM) in India [1,2]. Polypharmacy and multiple comorbidities make older patients more vulnerable to being prescribed potentially inappropriate medications (PIMs) [6]. PIM use in the older population is associated with increased morbidity and mortality, increased incidence of drug-related problems, adverse drug events, prolonged hospitalization, and an increased economic burden [8,9]. Older patients with type 2 diabetes mellitus (T2DM) are at greater risk of receiving potentially inappropriate medications (PIM) during hospitalization which may result in adverse outcomes. Aim: To evaluate the extent of PIM use in the older population with T2DM during hospitalization in a tertiary care hospital in India. Medications prescribed during hospitalization were reviewed following Beers Criteria 2019 to identify the extent of polypharmacy and PIM use. Significant factors associated with the use of PIM during hospitalization are patients taking a higher number of medications (odds ratio (OR): 7.85, 95% CI
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
