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Screening for Hypoglycaemia Risk and Medication Changes in Diabetes Patients Using Pharmacy Dispensing Data
Indriastuti Cahyaningsih1,2, Amal Asiri1,3, Stijn de Vos1
1Department of PharmacoTherapy, -Epidemiology, and -Economics, University of Groningen, 9713 AV Groningen, The Netherlands.
Journal of Clinical Medicine
|October 16, 2024
Summary
Many diabetes patients face high hypoglycemia risk, yet few receive treatment adjustments. Pharmacy data can identify those needing medication review to improve hypoglycemia management in primary care.
Area of Science:
- Pharmacology
- Endocrinology
- Health Services Research
Background:
- Effective hypoglycemia management in primary care requires better screening for at-risk patients.
- Routinely available data offers opportunities for identifying hypoglycemia risk and guiding treatment modifications.
Purpose of the Study:
- To quantify the number of diabetes patients at high risk of hypoglycemia using pharmacy dispensing data.
- To describe treatment changes in high-risk patients and identify associated patient characteristics.
Main Methods:
- A 1-year drug utilization cohort study using the IADB.nl pharmacy database.
- Inclusion of patients aged 35+ with at least two glucose-lowering medication dispensings in 2019.
- Validated algorithm for hypoglycemia risk scoring based on demographics and dispensing data; multinomial logistic regression for treatment change analysis.
Main Results:
- 26.9% of 36,628 patients had a high hypoglycemia risk score (≥0.6).
- 88.9% of high-risk patients had no diabetes treatment changes after 1 year.
- De-intensification occurred in 8.8%, intensification in 2.3%; high risk, female sex, and younger age were linked to de-intensification.
Conclusions:
- A significant proportion of primary care patients on glucose-lowering medications are at risk of hypoglycemia.
- Medication de-intensification is infrequent among high-risk patients, indicating a gap in care.
- Pharmacy dispensing data is a valuable tool for screening diabetes patients who require treatment review.
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