Related Experiment Video
Updated: Aug 29, 2025
07:31
Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
7.2K
Using an Electronic Health Record and Deficit Accumulation to Pragmatically Identify Candidates for Optimal
Kathryn E Callahan1,2, Kristin M Lenoir2,3, Chinenye O Usoh4
1Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC.
Diabetes Spectrum : a Publication of the American Diabetes Association
|September 9, 2022
Summary
Overtreatment with diabetes medications like insulin is common in frail older adults, despite guidelines suggesting less strict glycemic control. Tools like the electronic frailty index (eFI) can help identify patients for optimized prescribing interventions.
Area of Science:
- Gerontology
- Endocrinology
- Pharmacology
Background:
- Guidelines recommend less stringent glycemic control for older adults with type 2 diabetes.
- Overtreatment of type 2 diabetes in older adults is prevalent.
- Pragmatic approaches for prioritizing patients for optimal prescribing are lacking.
Purpose of the Study:
- To describe glycemic control and medication patterns in older adults with type 2 diabetes.
- To explore variability in glycemic control and medication patterns by frailty status.
Main Methods:
- Cross-sectional observational study using electronic health record (EHR) data.
- Participants were adults aged 65+ with type 2 diabetes within an accountable care organization (ACO).
- Frailty status determined by an automated EHR-based frailty index (eFI); diabetes management assessed by A1C and use of higher-risk medications (insulin/sulfonylurea).
Main Results:
- Among 16,973 older adults with type 2 diabetes, 53.8% were pre-frail and 36.6% were frail.
- Median A1C was 6.7%; 74.1% had A1C <7.5% and 38.3% had A1C <6.5%.
- Frailty status was not associated with glycemic control (P=0.08); however, 38.6% of frail patients with A1C <7.5% used insulin/sulfonylurea.
Conclusions:
- Treatment with insulin/sulfonylurea to achieve A1C <7.5% is common in frail older adults.
- The eFI can be a scalable tool for targeting optimal prescribing interventions in this population.
Related Concept Videos
01:30Methods of Documentation VII: EMR
893
Electronic Medical Records (EMRs) primarily center around electronically documenting patients' health information within a single healthcare organization or practice. They contain essential clinical data related to a patient's medical history, diagnoses, medications, treatment plans, lab results, and other pertinent information relevant to the specific encounter or episode of care. EMRs are designed to streamline documentation and workflow processes within individual healthcare...
893
01:22Diabetes Mellitus: Type 2 and Gestational
2.7K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.7K
01:15Diabetes: Management and Pharmacotherapy
341
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
341
01:22Diabetes Mellitus: Overview and Type I Subtype
3.0K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
3.0K
01:30Health Information Technology and Healthcare Information System
906
Health Information Technology (HIT)
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
Health Information Technology, commonly called HIT, integrates advanced information systems and technology in healthcare settings. Its primary functions include:
906
01:10Documentation of Nursing Diagnosis
1.3K
The nurse documents nursing diagnoses and enters them into the patient record. The identified patient's nursing diagnosis is either written out with a plan of care or entered into the electronic health record.
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
In some settings, data-driven computerized decision support systems are in place, allowing for more accurate nursing diagnoses. The database within one of these systems includes diagnostic labels defining characteristics, activities, and indicators for nursing. A nurse enters...
1.3K