노인의 퇴원 시 당뇨병 약제 강화 현황 및 단기 임상결과에 미치는 영향 분석 (Diabetes Medication Intensifications at Discharge in Older Adults: Prevalence and Impact on Short-Term Clinical Outcomes)

서지정보

· 발행기관 : 대한약물역학위해관리학회
· 수록지 정보 : 약물역학위해관리학회지 / 16권 / 1호 / 40 ~ 48페이지
· 저자명 : 이주연, 한주희, 정애희, 김민정, 정선회

초록

This study aimed to assess diabetes medication intensification at discharge in older adults hospitalized for non-glycemic reasons, examining its short term 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 diabetes related 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 post discharge 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 non glycemic issues was discharged with intensified diabetes medications, leading to improved short-term glycemic control but did not significantly affect diabetes related unplanned readmissions or emergency visits. (PeRM 2024;16:40-48)

영어초록

This study aimed to assess diabetes medication intensification at discharge in older adults hospitalized for non-glycemic reasons, examining its short term 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 diabetes related 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 post discharge 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 non glycemic issues was discharged with intensified diabetes medications, leading to improved short-term glycemic control but did not significantly affect diabetes related unplanned readmissions or emergency visits. (PeRM 2024;16:40-48)

참고자료

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