Antidiabetics' usage in type 2 diabetes mellitus: Are prescribing guidelines adhered to? A single centre study
Abstract
AIM: The primary aim of this study was to examine the prescribing patterns of antidiabetic agents (AA) in this hospital according to current prescribing contraindications (PCI). The secondary aims are to assess factors affecting the prescribing of AA and to evaluate the pharmacist impact on their prescribing.
METHOD: A retrospective cross sectional study was performed to review all prescribed AA over a 3 month period. Data extracted from medical records included: patients' demographics, management and pharmacists' interventions. Appropriateness of prescribing was determined according to the AA prescribing information of the Medical Index of Medical Specialities (MIMS).
RESULTS: A total of 314 AA were examined, of which 74(23%) orders were prescribed despite contraindications. Metformin was the AA to have the most PCI in dosage adjustments in renal impairment (RI). Logistic regression analysis showed patients with severe RI were less likely to be prescribed metformin (OR = 0.115 95%CI(0.048-0.274) P < 0.01), instead insulin was preferred (OR = 2.210 95%CI (1.028-4.751) P < 0.05). Insulin was also more likely to be prescribed in patients with hypertension and hyperglycaemia (OR=2.005 95%CI(1.005-4.001) P < 0.05, OR = 3.535 95%CI(1.756-7.113) P < 0.01) respectively. Sulphonylureas were less likely to be prescribed in patients with cardiovascular disease (OR = 0.339 95%CI(0.163-0.708), P < 0.01. There was low PCI in the other AA. Pharmacists reviewed 89% of AA. PCI was lower in…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
Read the paper
Related studies
- Metformin as an adjuvant in breast cancer treatment
- Metformin Lysosomal Targeting: A Novel Aspect to Be Investigated for Metformin Repurposing in Neurodegenerative Diseases?
- Aberrant HSF1 signaling activation underlies metformin amelioration of myocardial infarction in mice
- Metformin induces ZFP36 by mTORC1 inhibition in cervical cancer-derived cell lines
- Protein Interaction Network for Identifying Vascular Response of Metformin (Oral Antidiabetic)
- Preventing Long COVID With Metformin
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.