Academic Journal
Potential overtreatment in elderly patients with diabetes mellitus: Results from a cross-sectional study in German general practice.
| Τίτλος: | Potential overtreatment in elderly patients with diabetes mellitus: Results from a cross-sectional study in German general practice. |
|---|---|
| Συγγραφείς: | Weise S; Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany., Oelschläger C; Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany., Unverzagt S; Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany., Abendroth J; Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany., Heise M; Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany., Frese T; Institute of General Practice and Family Medicine, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle, Saale, Germany. |
| Πηγή: | The European journal of general practice [Eur J Gen Pract] 2025 Dec; Vol. 31 (1), pp. 2447723. Date of Electronic Publication: 2025 Feb 18. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Informa Healthcare Country of Publication: England NLM ID: 9513566 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1751-1402 (Electronic) Linking ISSN: 13814788 NLM ISO Abbreviation: Eur J Gen Pract Subsets: MEDLINE |
| Imprint Name(s): | Publication: London : Informa Healthcare Original Publication: [Amersfoort, The Netherlands] : Mediselect Pub., c1995- |
| Ιατρικοί όροι (MeSH): | General Practice*/statistics & numerical data , Hypoglycemic Agents*/therapeutic use , Diabetes Mellitus, Type 2*/therapy , Diabetes Mellitus, Type 2*/drug therapy , Diabetes Mellitus, Type 2*/blood , Overtreatment*/statistics & numerical data , Practice Patterns, Physicians'*/statistics & numerical data, Glycated Hemoglobin/metabolism ; Glycated Hemoglobin/analysis ; Humans ; Cross-Sectional Studies ; Aged ; Female ; Male ; Germany ; Aged, 80 and over |
| Περίληψη: | Background: It is important for general practitioners (GPs) to protect elderly patients with diagnosis of diabetes type 2 (DM2) from overtreatment. Objective: To analyse the metabolic control and treatment of elderly patients with DM2 in general practices. Methods: This cross-sectional study involved 46 general practices in a federal state of Germany. Inclusion criteria for patients were diagnosis of DM2, age of 70 years or above, no palliative care and at least one practice contact within the last six months. A study nurse randomly selected 10 eligible patients and extracted data on haemoglobin A1c (HbA1c), diabetes treatment, secondary prevention and GP's characteristics. Risk of overtreatment was defined as having a HbA1c <47.5 mmol/mol (6.5%) and receiving glucose-lowering drugs, and overtreatment as being at risk of overtreatment and being aged 80 years or above or living in a nursing home. Results: Among 460 participants, 36.0% received oral-antidiabetic drugs, 16.7% insulin, 16.2% both and 31.1% received diet/exercise. Overtreatment occurred in 12% of elderly patients with DM2, risk of overtreatment in 24%. Overtreatment was significantly associated with urban residency (OR 2.17). Female elderly patients with DM2 were significantly less often at risk of overtreatment (OR 0.59). Cluster effects were evident between general practices' treatment and monitoring of elderly patients with DM2 in quantitative data. Conclusion: Overtreatment is a relevant problem in elderly patients with DM2 for which GPs should regularly check and start deprescribing. Cluster effects suggest heterogeneity between general practices in diabetes management and monitoring. |
| References: | JAMA Intern Med. 2015 Mar;175(3):356-62. (PMID: 25581565) Diabetes Spectr. 2018 Aug;31(3):245-253. (PMID: 30140140) Diabet Med. 2019 Apr;36(4):399-413. (PMID: 30411402) Diabetes Care. 2013 Sep;36(9):2628-38. (PMID: 23628621) JAMA. 2002 Aug 14;288(6):756-64. (PMID: 12169083) J Am Geriatr Soc. 2018 Jul;66(6):1190-1194. (PMID: 29633237) Prim Care Diabetes. 2022 Jun;16(3):387-394. (PMID: 35400607) Diabetes Res Clin Pract. 2014 Jul;105(1):102-9. (PMID: 24853809) Int J Nurs Stud. 2023 Sep;145:104532. (PMID: 37315453) Diabet Med. 2021 Aug;38(8):e14500. (PMID: 33354827) Int J Clin Pract. 2021 Nov;75(11):e14847. (PMID: 34516684) Diabet Med. 2020 Aug;37(8):1333-1339. (PMID: 32506471) Lancet Diabetes Endocrinol. 2018 Apr;6(4):266-268. (PMID: 29033057) Drugs Aging. 2013 Oct;30(10):793-807. (PMID: 23912674) Trials. 2020 Jun 16;21(1):530. (PMID: 32546189) BMJ Open Diabetes Res Care. 2020 Feb;8(1):. (PMID: 32075810) Diabetes Care. 2013 Nov;36(11):3411-7. (PMID: 23877982) N Engl J Med. 2010 Oct 7;363(15):1410-8. (PMID: 20925543) Int J Clin Pract. 2015 Dec;69(12):1486-95. (PMID: 26422335) Diabet Med. 2017 Sep;34(9):1219-1227. (PMID: 28498634) BMC Endocr Disord. 2021 Mar 10;21(1):46. (PMID: 33691687) Diabetes Res Clin Pract. 2011 Jul;93(1):1-9. (PMID: 21382643) Fam Pract. 2012 Apr;29(2):196-202. (PMID: 21890842) Acta Diabetol. 2017 Feb;54(2):209-214. (PMID: 27837286) Diabetes Ther. 2020 May;11(5):1045-1059. (PMID: 32088879) Diabetes Care. 2022 Jan 1;45(Suppl 1):S195-S207. (PMID: 34964847) Endocrinol Nutr. 2014 Jun-Jul;61(6):311-7. (PMID: 24582291) Diabetes Care. 2020 Jan;43(Suppl 1):S152-S162. (PMID: 31862755) J Clin Med. 2022 Aug 31;11(17):. (PMID: 36079064) J Intern Med. 2008 Oct;264(4):340-50. (PMID: 18397244) |
| Contributed Indexing: | Keywords: Elderly; cross-sectional studies; diabetes mellitus type 2; general practice; overtreatment Local Abstract: [plain-language-summary] In our study in German general practice, 12% of elderly patients with DM2 were overtreated, 24% were at risk of overtreatment.GPs should regularly check for overtreatment and consequently start deprescribing.Policymakers may support these efforts by addressing overtreatment in chronic care programs and by ensuring adequate reimbursement. |
| Substance Nomenclature: | 0 (Hypoglycemic Agents) 0 (Glycated Hemoglobin) |
| Entry Date(s): | Date Created: 20250218 Date Completed: 20250508 Latest Revision: 20250508 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC11837937 |
| DOI: | 10.1080/13814788.2024.2447723 |
| PMID: | 39964188 |
| Βάση Δεδομένων: | MEDLINE |
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