Potentially inappropriate prescribing in individuals with type 2 diabetes mellitus: a Danish nationwide study

Abstract

Abstract Aim We aim to describe the prevalence of potentially inappropriate prescribing (PIP) in individuals with type 2 diabetes mellitus. Furthermore, we aim to explore associations between PIP and different individual-level factors. Subject and methods This was a nationwide register-based cross-sectional study. The study population consisted of all Danish citizens with type 2 diabetes as of 1 January 2022, and who were diagnosed at 40 years of age or older. Individual-level factors were sociodemographic variables, disease burden, and contacts with health care providers. The outcomes were PIP categorised as general or diabetes-related. General outcomes were assessed using the Screening Tool of Older Person’s Prescriptions and Screening Tool to Alert Doctors to Right Treatment (STOPP/START) criteria, and diabetes-related outcomes were defined according to selected guideline recommendations. Results We found that the prevalence of a general PIP omission affected nearly one third of the population. The most common type of under-prescribing was related to cardiovascular diseases. Similarly, the most prevalent of the four selected diabetes-related prescriptions was the non-initiation of recommended cardioprotective medication among individuals with type 2 diabetes and cardiovascular disease. The individual-level factors associated with PIP were female sex and living alone. Conclusion Future initiatives could focus on individuals with type 2 diabetes and cardiovascular diseases and consider the individual-level factors associated with increased risk to guide targeted interventions.