Adherence to antidiabetic drug therapy and reduction of fatal events in elderly frail patients
Authors' conclusion
In elderly diabetic patients, increased adherence to antidiabetic drugs is associated with a reduction in the risk of mortality regardless of the patients' clinical status and age, with the exception of very old patients (age ≥ 85 years) in the very poor or frail clinical category. However, in the frail patient category the benefit of treatment appears to be less than in patients in good clinical conditions.
Study context
- Population
- Patients aged ≥65 years with T2D from Lombardy (Italy) receiving ≥3 consecutive prescriptions of antidiabetic agents (mostly metformin and older conventional agents) during 2012cohort
- Participants
- 188,983 patients
- Comparison
- Higher vs lower adherence to antidiabetic drugs
- Casesn = 49,201
- Outcome
- All-cause mortality risk associated with adherence (proportion of follow-up days covered by prescriptions)
- Follow-up
- Up to 2018
Methodological detailspopulation-based, stratified by four categories of clinical status, Conditional logistic regression
- Population-based
- Stratified by four categories of clinical status
- Conditional logistic regression
Main finding
As reported in the abstract
All-cause mortality
- Progressive increase in adherence associated with progressive decrease in all-cause mortality risk in all clinical categories and at all ages (65-74, 75-84 and ≥85 years), except frail patients aged ≥85 years
- Mortality reduction from lowest to highest adherence tended to be lower in frail patients vs other categories
Observational data: associations, not effects.
Further findings
Cardiovascular mortality
- Similar although less consistent results
Original publication
Adherence to antidiabetic drug therapy and reduction of fatal events in elderly frail patients. Cardiovasc Diabetol. Published 10 March 2023. doi:10.
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