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Pharmacoepidemiology and Risk Management 2024; 16(1): 40-48

Published online March 31, 2024 https://doi.org/10.56142/perm.24.0002

Copyright © Korean Society for Pharmacoepidemiology and Risk Management.

Diabetes Medication Intensifications at Discharge in Older Adults: Prevalence and Impact on Short-Term Clinical Outcomes

노인의 퇴원 시 당뇨병 약제 강화 현황 및 단기 임상결과에 미치는 영향 분석

Ju-Hee Han1,2, Ae-Hee Jung1, Minjung Kim1, Sun-Hoi Jung1, Ju-Yeun Lee2

한주희1,2, 정애희1, 김민정1, 정선회1, 이주연2

1Department of Pharmacy, Boramae Medical Center, Seoul, Korea
2College of Pharmacy, Seoul National University, Seoul, Korea

1서울특별시보라매병원 약제부, 2서울대학교 약학대학

Correspondence to:Ju-Yeun Lee
College of Pharmacy, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 00826, Korea
Tel: +82-2-3668-7472
E-mail: jypharm@snu.ac.kr

Received: February 15, 2024; Revised: March 13, 2024; Accepted: March 15, 2024

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: This study aimed to assess diabetes medication intensification at discharge in older adults hospitalized for non-glycemic reasons, examining its shortterm benefits and risks. Methods: A retrospective review of electronic medical records from Boramae Medical Center (September 1, 2020, to August 31, 2022) was conducted. Medication intensification was defined as either increasing the dosage of existing diabetes medications, adding insulin or initiating new medications. We compared glycated hemoglobin (HbA1c) levels 90 days post-discharge and the incidence of blood glucose-related emergency department visits or diabetesrelated unplanned readmission within 90 days post-discharge between patients with and without medication intensification. Results: Out of 1,278 patients, 480 (37.6%) underwent medication intensification at discharge. Factors associated with intensification included longer hospital stays, consultations with endocrinologist, higher HbA1c at admission, frequent hyperglycemic events, and changes in steroid or immunosuppressant use. The intensification group showed a significant reduction (8.6% to 7.0%) in HbA1c 90 days post-discharge compared to the non-intensification group (6.9% to 6.9%, p < 0.001). However, there was no significant impact on postdischarge emergency visits or unplanned readmissions related to blood glucose (aOR 0.34; 95% CI 0.07–1.53). Conclusion: A third of older adults admitted for nonglycemic issues was discharged with intensified diabetes medications, leading to improved short-term glycemic control but did not significantly affect diabetesrelated unplanned readmissions or emergency visits.

KeywordsDiabetes mellitus, Hypoglycemic agent, Patient discharge, Aged, Blood glucose, Glycated hemoglobin

Korean Society for Pharmacoepidemiology and Risk Management

Vol.16 No.2
September, 2024

eISSN 2982-5954

Frequency: Bimonthly

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