Polypragmasia among the elderly with endocrine diseases in outpatient practice

The increase in life expectancy worldwide is accompanied by an increase in polymorbidity and polypragmasis. Elderly patients with endocrine diseases are at particular risk of polypragmasis, which involves the use of potentially irrational therapy (PIT) that increases the risks of adverse events (AEs), hospitalizations and mortality. Therefore, it is increasingly important to assess the prevalence of PIT use among older adults with endocrine disease. Aim. To assess the incidence of polypragmancy and analyze medication prescriptions for PIT using Beers 2023 criteria among elderly persons with endocrine disease in outpatient medical care. Material and methods. An observational one-stage multicenter single-sample uncontrolled study was conducted on the basis of the Grozny Republican Endocrinology Dispensary and other health care facilities of the Chechen Republic. Performed a review of 2023 outpatient medical records of patients aged 65 years and older for polypragmasy and PIT according to Beers 2023 criteria. Results. The study included 221 patients (58 men and 163 women), the median age was 68 years [66; 71]. Type 2 diabetes mellitus with multiple complications prevailed in the morbidity structure. When BMI was analyzed, grade 1 obesity was found in 37.6% of cases, with a statistically signifi cant higher prevalence in women than in men (72.4% vs 50.0%; p < 0.003, Fisher’s exact test). The median number of MP taken by patients was 4 [3; 5]. Prescription of 5 or more LS was observed in 110 patients (49.8%). When performing a comparative analysis of patients with and without polypragmasia, a statistically signifi cant diff erence by age was found (p < 0.017, Mann–Whitney test). The frequency of PIT prescription, which is represented by sulfonylurea derivatives, was 74/221 (33.5%). The frequency of prescription of SGLT-2 inhibitors, which should be used with caution according to the updated Beers criteria, was 50/221 (22.6%). No cases of AEs were registered against the background of PIT administration. Conclusion. Elderly patients with endocrine diseases are at high risk of polypragmasy and PIT prescribing. The use of Beers criteria will allow eff ective monitoring of the therapy and prevent the development of AEs. If there is no possibility of withdrawal of the drug or selection of an analog, the need for active monitoring of patients for the detection of AEs becomes obvious.

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