PMID- 37094748
OWN - NLM
STAT- MEDLINE
DCOM- 20230602
LR  - 20230607
IS  - 1538-9375 (Electronic)
IS  - 1525-8610 (Linking)
VI  - 24
IP  - 6
DP  - 2023 Jun
TI  - Medication Prescribing for Type 2 Diabetes in the US Long-Term Care Setting: 
      Observational Study.
PG  - 790-797.e4
LID - S1525-8610(23)00299-2 [pii]
LID - 10.1016/j.jamda.2023.03.020 [doi]
AB  - OBJECTIVES: To characterize prescribing of glucose-lowering medication annually 
      and to quantify the annual frequency of hypoglycemia among residents in long-term 
      care (LTC) facilities with type 2 diabetes mellitus (T2DM). DESIGN: Serial 
      cross-sectional study using a deidentified real-world database comprising 
      electronic health records from LTC facilities. SETTING AND PARTICIPANTS: 
      Individuals eligible for this study were >/=65 years old with T2DM and recorded 
      stay of >/=100 days at an LTC facility in the United States in any of 5 study years 
      (2016-2020), excluding individuals receiving palliative or hospice care. METHODS: 
      Drug orders (prescriptions) for glucose-lowering medications for each LTC 
      resident with T2DM in each calendar year were summarized by administration route 
      (oral or injectable) and by drug class as ever-prescribed (ie, multiple 
      prescriptions were included once), overall and stratified by age subgroup, <3 vs 
      >/=3 comorbidities, and obesity status. We calculated the annual percentage of 
      patients ever prescribed glucose-lowering medication each year, overall and by 
      medication category, who experienced >/=1 hypoglycemic events. RESULTS: Among 
      71,200 to 120,861 LTC residents with T2DM included each year from 2016 to 2020, 
      68% to 73% (depending on the year) were prescribed >/=1 glucose-lowering 
      medications, among them oral agents for 59% to 62% and injectable agents for 70% 
      to 71%. Metformin was the most commonly prescribed oral agent, followed by 
      sulfonylureas and dipeptidyl peptidase 4 inhibitors; basal plus prandial insulin 
      was the most commonly prescribed injectable regimen. Prescribing patterns 
      remained relatively consistent from 2016 to 2020, both overall and by patient 
      subgroup. During each study year, 35% of LTC residents with T2DM experienced 
      level 1 hypoglycemia (glucose >/=54 to <70 mg/dL), including 10% to 12% of those 
      prescribed only oral agents and >/=44% of those prescribed injectable agents. 
      Overall, 24% to 25% experienced level 2 hypoglycemia (glucose concentration 
      <54 mg/dL). CONCLUSIONS AND IMPLICATIONS: Study findings suggest that 
      opportunities exist for improving diabetes management for LTC residents with 
      T2DM.
CI  - Copyright (c) 2023 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Pandya, Naushira
AU  - Pandya N
AD  - Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, 
      Fort Lauderdale, FL, USA.
FAU - Jung, Molly
AU  - Jung M
AD  - Becton, Dickinson and Company, Franklin Lakes, NJ, USA.
FAU - Norfolk, Aaron
AU  - Norfolk A
AD  - PointClickCare, Mississauga, ON, Canada.
FAU - Goldblatt, Claudia
AU  - Goldblatt C
AD  - Becton, Dickinson and Company, Franklin Lakes, NJ, USA.
FAU - Trenery, Alyssa
AU  - Trenery A
AD  - embecta, Parsippany, NJ, USA.
FAU - Sieradzan, Ray
AU  - Sieradzan R
AD  - embecta, Parsippany, NJ, USA. Electronic address: Ray.Sieradzan@embecta.com.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20230421
PL  - United States
TA  - J Am Med Dir Assoc
JT  - Journal of the American Medical Directors Association
JID - 100893243
RN  - 0 (Hypoglycemic Agents)
RN  - IY9XDZ35W2 (Glucose)
SB  - IM
MH  - Humans
MH  - United States
MH  - Aged
MH  - *Diabetes Mellitus, Type 2/drug therapy
MH  - Long-Term Care
MH  - Cross-Sectional Studies
MH  - Hypoglycemic Agents/therapeutic use
MH  - *Hypoglycemia
MH  - Glucose/therapeutic use
OTO - NOTNLM
OT  - Glucose-lowering medication
OT  - hypoglycemia
OT  - insulin
OT  - long-term care
OT  - type 2 diabetes mellitus
EDAT- 2023/04/25 00:41
MHDA- 2023/06/02 06:42
CRDT- 2023/04/24 07:23
PHST- 2022/12/15 00:00 [received]
PHST- 2023/03/10 00:00 [revised]
PHST- 2023/03/15 00:00 [accepted]
PHST- 2023/06/02 06:42 [medline]
PHST- 2023/04/25 00:41 [pubmed]
PHST- 2023/04/24 07:23 [entrez]
AID - S1525-8610(23)00299-2 [pii]
AID - 10.1016/j.jamda.2023.03.020 [doi]
PST - ppublish
SO  - J Am Med Dir Assoc. 2023 Jun;24(6):790-797.e4. doi: 10.1016/j.jamda.2023.03.020. 
      Epub 2023 Apr 21.