Poor therapeutic adherence in a type 2 diabetes mellitus elderly patient with cognitive impairment and polypharmacy

Authors

  • Luis Miguel Pérez-Belmonte Servicio de Medicina Interna, Hospital Regional Universitario de Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA). Universidad de Málaga (UMA), Málaga, Spain
  • Mercedes Florido-Santiago Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias (CIMES). Facultad de Medicina, Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
  • Michele Ricci Servicio de Medicina Interna, Hospital Regional Universitario de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA). Universidad de Málaga (UMA), Málaga, España
  • José Pablo Lara-Muñoz Unidad de Neurofisiología Cognitiva, Centro de Investigaciones Médico Sanitarias (CIMES). Facultad de Medicina, Universidad de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
  • Ricardo Gómez-Huelgas Servicio de Medicina Interna, Hospital Regional Universitario de Málaga. Instituto de Investigación Biomédica de Málaga (IBIMA). Universidad de Málaga (UMA), Málaga, Spain

DOI:

https://doi.org/10.32818/reccmi.a5s1a17

Keywords:

frailty, polypharmacy, type 2 diabetes, hypoglycemia, cognitive impairment.

Abstract

A 84-years-old woman with long-duration type 2 diabetes, severe cognitive impairment, frailty and polypharmacy came with episodes of dizziness and palpitations that improved after eating, but occasionally causing secondary falls. Frequently, the caretaker did not give her the antidiabetic medication, suspecting drug-induced hypoglycemia. After antidiabetic treatment optimization, the hypoglycemias were avoided and the therapeutic adherence was safely improved.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Kalyani RR, Saudek CD, Brancati FL, Selvin E. Association of diabetes, comorbidities, and A1C with functional disability in older adults: results from the National Health and Nutrition Examination Survey (NHANES), 1999-2006. Diabetes Care. 2010; 33(5): 1055-1060. doi: https://doi.org/10.2337/dc09-1597.

Fialová D, Topinková E, Gambassi G, Finne-Soveri H, Jónsson PV, Carpenter I, et al.; AdHOC Project Research Group. Potentially inappropriate medication use among elderly home care patients in Europe. JAMA. 2005; 293(11): 1348-1358. doi: https://doi.org/10.1001/jama.293.11.1348.

Formiga F, Vidal X, Agustí A, Chivite D, Rosón B, Barbé J, et al; Potentially Inappropriate Prescription in Older Patients in Spain (PIPOPS) Investigators’ Project. Inappropriate prescribing in elderly people with diabetes admitted to hospital. Diabet Med. 2016; 33(5): 655-662. doi: https://doi.org/10.1111/dme.12894.

Pasina L, Brucato AL, Falcone C, Cucchi E, Bresciani A, Sottocorno M, et al. Medication non-adherence among elderly patients newly discharged and receiving polypharmacy. Drugs Aging. 2014; 31(4): 283-289. doi: https://doi.org/10.1007/s40266-014-0163-7.

Aikens JE, Piette JD. Longitudinal association between medication adherence and glycaemic control in type 2 diabetes. Diabet Med. 2013; 30(3): 338-344. doi: https://doi.org/10.1111/dme.12046.

Currie CJ, Peyrot M, Morgan CL, Poole CD, Jenkins-Jones S, Rubin RR, et al. The impact of treatment noncompliance on mortality in people with type 2 diabetes. Diabetes Care. 2012 Jun; 35(6): 1279-1284. doi: https://doi.org/10.2337/dc11-1277.

Rodríguez-Manas L. A call for action in diabetes care for older people. Diabet Med. 2011; 28(7): 757-758. doi: https://doi.org/10.1111/j.1464-5491.2011.03335.x.

Sánchez-Benavides G, Peña-Casanova J, Casals-Coll M, Gramunt N, Moli- nuevo JL, Gómez-Ansón B, et al.; NEURONORMA Study Team. Cognitive and neuroimaging profiles in mild cognitive impairment and Alzheimer’s disease: data from the Spanish Multicenter Normative Studies (NEURONORMA Project). J Alzheimers Dis. 2014; 41(3): 887-901. doi: https://doi.org/10.3233/JAD-132186.

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al.; Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001; 56(3): M146-156. doi: https://doi.org/10.1093/gerona/56.3.m146.

Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965; 14: 61-65.

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care. 1986; 24(1): 67- 74. doi: https://doi.org/10.1097/00005650-198601000-00007.

Tricco AC, Ivers NM, Grimshaw JM, Moher D, Turner L, Galipeau J, et al. Effectiveness of quality improvement strategies on the management of diabetes: a systematic review and meta-analysis. Lancet. 2012; 379(9833): 2252- 2261. doi: https://doi.org/10.1016/S0140-6736(12)60480-2.

Gómez-Huelgas R, Gómez Peralta F, Rodríguez Mañas L, Formiga F, Puig Domingo M, Mediavilla Bravo JJ, et al. Treatment of type 2 diabetes mellitus in elderly patients. Rev Clin Esp. 2018; 218(2): 74-88. doi: https://doi.org/10.1016/j.rce.2017.12.003.

Yang J, Huang C, Wu S, Xu Y, Cai T, Chai S, et al. The effects of dipeptidyl peptidase-4 inhibitors on bone fracture among patients with type 2 diabetes mellitus: a network meta-analysis of randomized controlled trials. PLoS One. 2017; 12(12): e0187537. doi: https://doi.org/10.1371/journal.pone.0187537.

Published

2020-03-31

How to Cite

1.
Pérez-Belmonte LM, Florido-Santiago M, Ricci M, Lara-Muñoz JP, Gómez-Huelgas R. Poor therapeutic adherence in a type 2 diabetes mellitus elderly patient with cognitive impairment and polypharmacy. Rev Esp Casos Clin Med Intern [Internet]. 2020 Mar. 31 [cited 2024 May 16];5:45-7. Available from: https://www.reccmi.com/RECCMI/article/view/525

Most read articles by the same author(s)

1 2 > >>