- 作者：Gillian E. Caughey ; Elizabeth E. Roughead ; Agnes I. Vitry ; Robyn A. McDermott ; Sepehr Shakib ; Andrew L. Gilbert
- 关键词：Diabetes ; Comorbidity ; Inappropriate prescribing ; Elderly ; Polypharmacy
- 刊名：Diabetes Research and Clinical Practice
- 出版年：2010
- 出版时间：March 2010
- 年：2010
- 卷：87
- 期：3
- 页码：385-393
- 全文大小：290 K
AimsTo investigate the prevalence of comorbid conditions in the elderly with diabetes and the prescribing of potentially inappropriate medicines or treatment conflicts.Methods
A cross-sectional study of diabetics aged ≥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.
Results
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.
Conclusion
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.