Original Research
Monday, October 14, 2024
01:00 PM–02:30 PM
Abstract
Introduction: Hospitalized patients with diabetes are at a high risk of adverse drug events and readmissions following discharge. Improved medication management during transitions of care represents an opportunity to avoid these undesired outcomes and improve disease control while managing comorbid conditions such as cardiovascular disease.
Research Question or Hypothesis: What are the patient factors associated with suboptimal prescribing of antidiabetic medications at hospital discharge?
Study Design: Retrospective cohort study.
Methods: Patients =18 years old with a history of type 2 diabetes admitted to a general medicine unit between January and November of 2023 were eligible for inclusion. The primary endpoint was to determine patient factors associated with guideline discordant prescribing of antidiabetic medications at hospital discharge. Changes made to patient’s home regimens were assessed. Binary logistic regression was used to calculate an odds ratio (OR) with 95% confidence interval (CI) for factors associated with appropriate prescribing at discharge. Changes percentage of patients prescribed each medication class at discharge were assessed with a chi-squared test (SAS version 9.4).
Results: Out of 150 patients included, 58 (38.7%) were discharged home on an antihyperglycemic regimen including preferred agents for their specific comorbidities and appropriate therapy escalations. Three factors were associated with suboptimal prescribing of antidiabetic medications including age (OR 1.03 [95%CI 1.001-1.06), p=0.04), hemoglobin A1c (HbA1c) (OR 1.40 [95%CI 1.12-1.74], p=0.003) and history of stroke (OR 2.44 [95%CI 1.06-5.63], p=0.04). Significant differences were found in the proportion of patients prescribed several medication classes between admission and discharge including metformin (60 vs. 54%, p=0.007), Sodium-glucose transport protein 2 inhibitors (23% vs. 34%, p<0.001), sulfonylureas (34% vs. 26%, p=0.005), basal insulin (44% vs. 50%, p=0.03), and sliding scale insulin (13% vs. 19%, p=0.02).
Conclusion: This study demonstrated opportunities to improve prescribing of antidiabetic medications at hospital discharge. Future studies are warranted to address the role of pharmacists to improve medication use in this patient population.
Presenting Author
Collin M. Clark PharmD, BCPS, BCGPUniversity at Buffalo Jacobs School of Medicine and Biomedical Sciences
Authors
Allison Holdsworth PharmD
Buffalo General Medical Center
Brian Kersten PharmD, BCPS, BCCCP
Buffalo General Medical Center
Maggie Lycouras PharmD, BCPS
Buffalo General Medical Center
Stephanie Seyse PharmD, BCPS, FASHP, CACP
Kaleida Health/Buffalo General Medical Center