Novel tool spots potentially inappropriate prescribing in T2D patients

A new tool for identifying potentially inappropriate prescribing (PIP) in people with type 2 diabetes (T2D) has been validated in the outpatient setting, according to an Ethiopian study.

A group of researchers designed IMPACT2DM* to detect PIP in adults with T2D. This novel tool identified at least one PIP in >90 percent of medical records, with prescribing omission (80.9 percent) as the most common type of PIP.

Prescribing omissions in adults were significantly associated with age ≥40 years and prescription with <5 medications. In addition, dosing problems in adults occurred in those aged ≥50 years or those who had a fasting blood sugar level out of the target range (80‒130 mg/dL).

“IMPACT2DM is a clinically valid PIP identification tool for application in an Ethiopian outpatient setting,” the researchers said. “Health professionals should be alert to check for potential prescribing omissions for adults ≥40 years old and dosing problems for adults with an FBS level out of the target range or >50 years.”

This cross-sectional study used data obtained retrospectively from the medical records of adults being managed for T2D at Debretabore Hospital.

IMPACT2DM was used to examine PIP. Some items or components of this new tool were modified to increase its applicability in the outpatient setting, to clarify content, or to use the terms most common in this setting. The researchers also identified the factors associated with PIP using multivariant logistic regression analyses.

“People with T2D are at greater risk of PIP due to multiple comorbidities and polypharmacy,” the researchers said. “IMPACT2DM is a tool designed to identify PIP for adults with T2D.” 

*Inappropriate Medication Prescribing Assessment Criteria for Type 2 Diabetes Mellitus