PMID- 30315498
OWN - NLM
STAT- MEDLINE
DCOM- 20190318
LR  - 20210323
IS  - 1179-1918 (Electronic)
IS  - 1173-2563 (Linking)
VI  - 39
IP  - 1
DP  - 2019 Jan
TI  - Physicians' and Pharmacists' Clinical Considerations for Elderly Patients with 
      Type 2 Diabetes Mellitus: The IMPLICA2 Study.
PG  - 73-84
LID - 10.1007/s40261-018-0713-6 [doi]
AB  - BACKGROUND: Management of elderly patients with type 2 diabetes mellitus (T2DM) 
      is complex due to their age-related conditions. Several clinical guidelines 
      provide specific recommendations for management of these patients but little is 
      known about their implementation in clinical practice. OBJECTIVE: To describe 
      physician and community pharmacist perceptions and routine clinical practice in 
      the management of elderly T2DM patients. METHODS: Cross-sectional study. RESULTS: 
      A total of 993 physicians and 999 community pharmacists completed the 
      questionnaire. More physicians than pharmacists agreed on the need to establish 
      more flexible HbA1c targets for elderly (79.4% vs. 30.6%; p < 0.001) and frail 
      (92.6% vs. 31.4%; p < 0.001) patients than for the general diabetic population. 
      HbA1c targets < 7.5% for elderly patients and < 8.5% for frail patients (as 
      recommended by the principle guidelines) were set by 38.9% and 28.7% of 
      physicians, respectively. Furthermore, 62.8% of physicians stated they follow 
      guideline recommendations but, based on their prescription decisions for 
      hypothetical patients, less than 50% were aligned with them. In addition, 73.1% 
      of physicians monitor treatment adherence, mainly by using dispensing control 
      (59.1%). Specific nutritional approaches for elderly patients are provided by 
      62.9% of physicians and 56.0% of pharmacists, whilst 57.4% and 21.7%, 
      respectively, deliver specific physical exercise programs. CONCLUSIONS: Low 
      adherence to guideline recommendations (i.e. setting more stringent HbA1c targets 
      or delaying treatment intensification) may lead to suboptimal glycaemic control 
      in elderly patients. The standardization of processes, extensive monitoring of 
      patient treatment adherence and providing advice regarding specific personal 
      lifestyle habits may improve the management of elderly T2DM patients.
FAU - Franch-Nadal, Josep
AU  - Franch-Nadal J
AD  - CAP Drassanes Raval-Sud, Barcelona, Spain.
AD  - CIBER of Diabetes and Associated Metabolic Diseases (CIBERDEM), Madrid, Spain.
FAU - Garcia-Gollarte, Fermin
AU  - Garcia-Gollarte F
AD  - Ballesol Mediterraneo Nursing Home Group, Valencia, Spain.
FAU - Perez Del Molino, Alfonso
AU  - Perez Del Molino A
AD  - Hospital of Sierrallana, Cantabria, Spain.
FAU - Orera-Pena, Maria L
AU  - Orera-Pena ML
AD  - Medical Affairs at Mylan, C/ General Aranaz n masculine 86, 28027, Madrid, Spain.
FAU - de Miguel, Marta Rodriguez
AU  - de Miguel MR
AD  - Medical Affairs at Mylan, C/ General Aranaz n masculine 86, 28027, Madrid, Spain.
FAU - Melogno-Klinkas, Malena
AU  - Melogno-Klinkas M
AD  - Medical Affairs at Mylan, C/ General Aranaz n masculine 86, 28027, Madrid, Spain.
FAU - de Paz, Hector D
AU  - de Paz HD
AD  - Outcomes'10, Castellon, Spain.
FAU - Aceituno, Susana
AU  - Aceituno S
AD  - Outcomes'10, Castellon, Spain.
FAU - Rodriguez-Fortunez, Patricia
AU  - Rodriguez-Fortunez P
AD  - Medical Affairs at Mylan, C/ General Aranaz n masculine 86, 28027, Madrid, Spain. 
      patricia.rodriguezfortunez@mylan.com.
LA  - eng
PT  - Journal Article
PL  - New Zealand
TA  - Clin Drug Investig
JT  - Clinical drug investigation
JID - 9504817
SB  - IM
MH  - Adult
MH  - Cross-Sectional Studies
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pharmacists/*organization & administration
MH  - Surveys and Questionnaires
EDAT- 2018/10/14 06:00
MHDA- 2019/03/19 06:00
CRDT- 2018/10/14 06:00
PHST- 2018/10/14 06:00 [pubmed]
PHST- 2019/03/19 06:00 [medline]
PHST- 2018/10/14 06:00 [entrez]
AID - 10.1007/s40261-018-0713-6 [pii]
AID - 10.1007/s40261-018-0713-6 [doi]
PST - ppublish
SO  - Clin Drug Investig. 2019 Jan;39(1):73-84. doi: 10.1007/s40261-018-0713-6.