Comorbidity in the elderly with diabetes: identification of areas of potential treatment conflicts

Caughey, Gillian E., Roughead, Elizabeth E., Vitry, Agnes I., McDermott, Robyn A., Shakib, Sepehr, and Gilbert, Andrew L. (2010) Comorbidity in the elderly with diabetes: identification of areas of potential treatment conflicts. Diabetes Research and Clinical Practice, 87 (3). pp. 385-393.

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Aims: To 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.

Item ID: 35799
Item Type: Article (Research - C1)
ISSN: 1872-8227
Keywords: diabetes, comorbidity, inappropriate prescribing, elderly, polypharmacy
Funders: Australian Research Council (ARC), National Health and Medical Research Council of Australia (NHMRC)
Date Deposited: 15 Oct 2014 16:48
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111702 Aged Health Care @ 100%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920502 Health Related to Ageing @ 100%
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