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

Gillian Caughey, Elizabeth E. Roughead, Agnes Vitry, Robyn A. McDermott, Sepehr Shakib, Andrew L. Gilbert

Research output: Contribution to journalArticle

106 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)385-393
Number of pages9
JournalDiabetes Research and Clinical Practice
Volume87
Issue number3
DOIs
Publication statusPublished - 1 Mar 2010
Externally publishedYes

Keywords

  • Comorbidity
  • Diabetes
  • Elderly
  • Inappropriate prescribing
  • Polypharmacy

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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