Fadil Haifa A, Alrehaili Ziyad S, Alharbi Khaled M, Almuzaini Abdulaziz F, Alharbi Raed Hamed, Alharbi Hindi S, Elbadawy Hossein M, Alahmadi Yaser M
Department of Pharmacy Practice, College of Pharmacy, Taibah University, Madinah, Kingdom of Saudi Arabia.
Medical and Pharmaceutical Services, Pharmacy Department, General Directorate of Medical Services Ministry of Interior, Riyadh, Kingdom of Saudi Arabia.
Risk Manag Healthc Policy. 2024 Dec 19;17:3227-3238. doi: 10.2147/RMHP.S484334. eCollection 2024.
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.
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.
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.
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.
全球人口老龄化给药物管理带来了挑战，尤其是在易受潜在不适当用药（PIM）影响的老年糖尿病患者中。PIM可导致低血糖、跌倒、认知衰退和住院等不良后果，影响生活质量和生存率。本研究旨在使用美国老年医学会2023年更新的《Beers标准》评估沙特阿拉伯一家三级医院中糖尿病老年患者的PIM患病率。
在一家三级医院对480名60岁及以上的糖尿病成年患者进行了为期3个月的横断面回顾性研究。从电子健康记录中提取包括人口统计学、合并症和用药情况等数据。遵循2023年美国老年医学会更新的《Beers标准》。
中位年龄为66岁，男性占主导（62.7%）。外周血管疾病（42.7%）和既往心肌梗死（22.7%）是常见的合并症。在17.7%的胰岛素使用者中观察到胰岛素使用不当，主要是使用短效胰岛素而未使用基础/长效胰岛素。约39.2%的患者被开具了《Beers标准》认定为不适当的抗糖尿病药物，其中格列齐特最为常见（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，但仍有一半的患者接受了警示药物，而只有4.2%的患者发生了此类感染。
该研究突出了沙特阿拉伯麦地那糖尿病老年患者中PIM的患病率。遵循《Beers标准》指南对于优化该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。
