Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Australia.
Diabetes Res Clin Pract. 2010 Mar;87(3):385-93. doi: 10.1016/j.diabres.2009.10.019. Epub 2009 Nov 17.
To investigate the prevalence of comorbid conditions in the elderly with diabetes and the prescribing of potentially inappropriate medicines or treatment conflicts.
A cross-sectional study of diabetics aged >or=65 years, using prescription dispensing data from the Australian Department of Veterans' Affairs. Comorbidities were determined using the comorbidity index Rx-Risk-V. Potentially inappropriate prescribing or treatment conflicts specific for the elderly were determined from guidelines or reference compendia, in addition to the 2003 updated Beers criteria.
Of 18,968 diabetics, the median number of comorbidities was 5 (IQR 3-8). Diabetes and associated cardiovascular medicines accounted for 41.9% of all medicine use. Associated cardiovascular diseases were highly prevalent comorbidities. 46% had gastro-oesophageal reflux disease, 25% depression, 20% chronic airways disease or chronic pain and 15% also had heart failure or inflammation-pain. At least 16% were dispensed a medicine associated with adverse effects in patients with diabetes and 22.7% were dispensed at least one potentially inappropriate medicine.
Significant comorbid conditions in elderly diabetic patients with potential for inappropriate prescribing or treatment conflicts include arthritis, heart failure, chronic airways diseases and diseases treatable with systemic corticosteroids. Appropriate management of comorbidity should be included in guidelines for the elderly with diabetes.
调查老年糖尿病患者合并症的流行情况，以及潜在不适当用药或治疗冲突的情况。
这是一项针对年龄≥65 岁的糖尿病患者的横断面研究，使用澳大利亚退伍军人事务部的处方配药数据。使用 Rx-Risk-V 合并症指数确定合并症。除了 2003 年更新的 Beers 标准外，还根据指南或参考手册确定了特定于老年人的潜在不适当用药或治疗冲突。
在 18968 名糖尿病患者中，中位数合并症数量为 5（IQR 3-8）。糖尿病及其相关心血管药物占所有药物使用的 41.9%。相关心血管疾病是高度流行的合并症。46%的患者患有胃食管反流病，25%的患者患有抑郁症，20%的患者患有慢性气道疾病或慢性疼痛，15%的患者同时患有心力衰竭或炎症-疼痛。至少有 16%的患者被开具了与糖尿病患者不良反应相关的药物，22.7%的患者被开具了至少一种潜在不适当的药物。
老年糖尿病患者存在多种合并症，可能存在不适当的用药或治疗冲突，包括关节炎、心力衰竭、慢性气道疾病和可通过全身皮质类固醇治疗的疾病。适当的合并症管理应包括在老年糖尿病患者的指南中。
