PMID- 31494916
OWN - NLM
STAT- MEDLINE
DCOM- 20201104
LR  - 20201104
IS  - 1720-8319 (Electronic)
IS  - 1594-0667 (Linking)
VI  - 32
IP  - 8
DP  - 2020 Aug
TI  - Optimizing drug therapy in frail patients with type 2 diabetes mellitus.
PG  - 1551-1559
LID - 10.1007/s40520-019-01342-z [doi]
AB  - BACKGROUND: Type 2 diabetes mellitus (T2DM) is closely linked with ageing. In 
      frail diabetic patients, the risks of intensive antidiabetic therapy outweigh the 
      potential benefits. AIMS: To study the prevalence of T2DM in frail elderly 
      patients, to identify inappropriate prescription (IP) of antidiabetic drugs and 
      to study the relationship between patients' frailty index (FI) with polypharmacy 
      and IP. METHODS: This was a prospective, descriptive, observational study of 
      elderly patients. Each patient's antidiabetic treatment was analysed by applying 
      the patient-centred prescription model (PCP), which centres therapeutic decisions 
      on the patient's global assessment and individual therapeutic goal. RESULTS: 210 
      patients with T2DM were included (25.15% prevalence). They were characterised by 
      high multimorbidity and frailty. 93.3% presented polypharmacy and 51% excessive 
      polypharmacy. IP was identified in 66.2% of patients. A statistically significant 
      relationship was found between the progression in FI degree and IP prevalence 
      (p < 0.05. During the admission, drug therapy regimens were modified in 97.1% of 
      cases with IP (n = 136). DISCUSSION: These results suggest that in clinical 
      practice T2DM treatment is not individualised, but rather is based on the same 
      general recommendations for the population as a whole. CONCLUSIONS: There is a 
      high prevalence of T2DM in the elderly. As the frailty of patients increases, so 
      does the prevalence of IP. The application of PCP model enables drug therapy 
      optimization in frail patients according to their main therapeutic goal, and 
      contributes to provide clinical evidences on the applicability of a set of 
      knowledge areas from the theoretical framework to the daily clinical practice.
FAU - Molist-Brunet, N
AU  - Molist-Brunet N
AUID- ORCID: 0000-0003-0138-6278
AD  - Hospital Universitari de la Santa Creu de Vic, Rambla Hospital, 52, 08500, Vic, 
      Barcelona, Spain. nmolist@gmail.com.
AD  - Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social 
      Care Research (CESS), Universitat de Vic-University of Vic-Central University of 
      Catalonia (UVIC-UCC), C. Miquel Marti i Pol, C/Francesc Pla "El Vigata", 1, 
      08500, Vic, Spain. nmolist@gmail.com.
FAU - Sevilla-Sanchez, D
AU  - Sevilla-Sanchez D
AD  - Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social 
      Care Research (CESS), Universitat de Vic-University of Vic-Central University of 
      Catalonia (UVIC-UCC), C. Miquel Marti i Pol, C/Francesc Pla "El Vigata", 1, 
      08500, Vic, Spain.
AD  - Hospital Universitari de Vic, C/Francesc Pla "El Vigata", 1, 08500, Vic, 
      Barcelona, Spain.
FAU - Puigoriol-Juvanteny, E
AU  - Puigoriol-Juvanteny E
AD  - Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social 
      Care Research (CESS), Universitat de Vic-University of Vic-Central University of 
      Catalonia (UVIC-UCC), C. Miquel Marti i Pol, C/Francesc Pla "El Vigata", 1, 
      08500, Vic, Spain.
AD  - Hospital Universitari de Vic, C/Francesc Pla "El Vigata", 1, 08500, Vic, 
      Barcelona, Spain.
FAU - Gonzalez-Bueno, J
AU  - Gonzalez-Bueno J
AD  - Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social 
      Care Research (CESS), Universitat de Vic-University of Vic-Central University of 
      Catalonia (UVIC-UCC), C. Miquel Marti i Pol, C/Francesc Pla "El Vigata", 1, 
      08500, Vic, Spain.
AD  - Hospital Universitari de Vic, C/Francesc Pla "El Vigata", 1, 08500, Vic, 
      Barcelona, Spain.
FAU - Sola-Bonada, N
AU  - Sola-Bonada N
AD  - Hospital Universitari de Vic, C/Francesc Pla "El Vigata", 1, 08500, Vic, 
      Barcelona, Spain.
FAU - Cruz-Grullon, M
AU  - Cruz-Grullon M
AD  - Hospital Universitari de la Santa Creu de Vic, Rambla Hospital, 52, 08500, Vic, 
      Barcelona, Spain.
FAU - Espaulella-Panicot, J
AU  - Espaulella-Panicot J
AD  - Hospital Universitari de la Santa Creu de Vic, Rambla Hospital, 52, 08500, Vic, 
      Barcelona, Spain.
AD  - Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social 
      Care Research (CESS), Universitat de Vic-University of Vic-Central University of 
      Catalonia (UVIC-UCC), C. Miquel Marti i Pol, C/Francesc Pla "El Vigata", 1, 
      08500, Vic, Spain.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20190907
PL  - Germany
TA  - Aging Clin Exp Res
JT  - Aging clinical and experimental research
JID - 101132995
SB  - IM
MH  - Aged
MH  - *Diabetes Mellitus, Type 2/drug therapy/epidemiology
MH  - *Frail Elderly
MH  - *Frailty/epidemiology
MH  - Geriatric Assessment
MH  - Humans
MH  - *Polypharmacy
MH  - Prospective Studies
OTO - NOTNLM
OT  - Frailty
OT  - Inappropriate prescription
OT  - Patient-centred care
OT  - Polypharmacy
EDAT- 2019/09/09 06:00
MHDA- 2020/11/05 06:00
CRDT- 2019/09/09 06:00
PHST- 2019/07/11 00:00 [received]
PHST- 2019/08/27 00:00 [accepted]
PHST- 2019/09/09 06:00 [pubmed]
PHST- 2020/11/05 06:00 [medline]
PHST- 2019/09/09 06:00 [entrez]
AID - 10.1007/s40520-019-01342-z [pii]
AID - 10.1007/s40520-019-01342-z [doi]
PST - ppublish
SO  - Aging Clin Exp Res. 2020 Aug;32(8):1551-1559. doi: 10.1007/s40520-019-01342-z. 
      Epub 2019 Sep 7.