Iatrogenic hypoglycemia–related hospital admissions identified through databases: economic burden and causes

Richard, Tiphaine; Issa, Romane; Andrès, Emmanuel; Gourieux, B.; Jeandidier, N.; Michel, Bruno

doi:10.1007/s11096-019-00877-5

Cited by 6 publications

(3 citation statements)

References 22 publications

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“…The primary objective of medico-administrative databases such as ERASME is to provide information about payment of medical care but their usefulness is now well accepted to study health-care issues. 21 The use of ERASME had however some limitations. Firstly, patients who were not insured under the general scheme were not taken into account.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Medication adherence and persistence among patients with non-small cell lung cancer receiving tyrosine kinase inhibitors and estimation of the economic burden associated with the unused medicines

Joret¹,

Matti

Beck

et al. 2021

J Oncol Pharm Pract

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Background Non–small cell lung cancer (NSCLC) is a leading cause of cancer deaths. Its treatment includes specific oral tyrosine kinases inhibitors (TKIs). Objectives To estimate adherence and persistence among patients receiving TKIs and to assess the economic burden of the unused medicines in Alsace (France). Method This retrospective study was carried out using the Insurance Healthcare database. Main outcome measures Adherence was calculated using medication possession ratio (MPR), persistence using estimated level of persistence with therapy (ELPT) and economic impact using prescription refill data. Results 242 patients were receiving TKIs. The most common TKIs prescribed were erlotinib (75.6%, n = 183) and crizotinib (12.8%, n = 31). Total of 149 patients were included in the adherence analysis. Overall MPR was 0.98. 180 patients were included in the persistence analysis. Almost half of patients had stopped treatment at 60 days and only 38.3% (n = 69) were still persistent with the therapy at 120 days. The expenses related to unused TKIs amounted to €356,392 and were related majorly to treatment discontinuation followed by overlapping refills, patient deaths and dose- or drug-switching, respectively. Conclusions Our data indicated overall adherence medicines above the acceptable limit of 0.80 but also pointed out a significant decline in persistence over time. The resulting economic losses justify the need for physicians and pharmacists to closely monitor their patients to ensure continuity of treatment. To limit the cost associated with unused medicines, interventions such as app-based monitoring, dispensing TKIs per unit over shorter periods and not only on monthly intervals could be implemented.

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Section: Strengths and Limitationsmentioning

confidence: 99%

Medication adherence and persistence among patients with non-small cell lung cancer receiving tyrosine kinase inhibitors and estimation of the economic burden associated with the unused medicines

Joret¹,

Matti

Beck

et al. 2021

J Oncol Pharm Pract

Self Cite

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“…16,17 Severe hypoglycaemia is an avoidable healthcare cost. 18,19 Unlike mainland France, diabetes is more prevalent in women than in men in French Guiana, probably because obesity is more frequent in women. 6 A recent study in 2017 showed that among those aged ≥45 years, the prevalence of diabetes was higher in women than that in men: 18% versus 14% respectively.…”

Section: Introductionmentioning

confidence: 99%

“…It also results from administration errors and/or drug interactions 16,17 . Severe hypoglycaemia is an avoidable healthcare cost 18,19 …”

Section: Introductionmentioning

confidence: 99%

Risk factors for hypoglycaemia in people with diabetes admitted to the Emergency Department of a Hospital in French Guiana

et al. 2021

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Aims/Introduction: Strict management of glucose levels in elderly people with diabetes or with comorbidities exposes them to the risk of severe hypoglycaemia (capillary or venous glucose ≤3.3 mmol/L) and the associated morbidity and mortality. We aimed to describe the clinical, laboratory, and epidemiological characteristics of people with diabetes admitted to the Emergency Department in Cayenne, French Guiana for severe hypoglycaemia and identify avoidable behaviours in this population. Materials and Methods:An observational epidemiological study of adults with diabetes who presented to the Emergency Department with severe hypoglycaemia was conducted between 2015 and 2018. Their medical history, clinical and laboratory data were collected. The primary outcome was the association between therapeutic misuse and age ≥65 years.Results: Overall, 178 admissions were analysed. The main cause of hypoglycaemia was insulin dosing-error or inappropriate glycaemic targets. Among those ≥65 years, 59% had a glycated haemoglobin ≤48 mmol/mol (6.5%), and the median duration of their diabetes was 20 years. Among them, 60% were treated with sulfonylurea, repaglinide, biphasic insulin, or mixed drugs, and 48% were on nondiabetes related treatments that had a hypoglycaemic effect. Furthermore, 23% of the elderly treated with oral antidiabetics had chronic kidney disease. Conclusion: Many avoidable risk factors for severe hypoglycaemia have been highlighted, in particular insulin dosing errors or non-compliance with recommendations for participants ≥ 65 years. Primary care physicians and homecare nurses need to provide preventive interventions and undergo training.

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Diabetes Mellitus: Classification and Diagnosis

Marchetti,

Baronti,

Boggi

et al. 2023

Transplantation of the Pancreas

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Iatrogenic hypoglycemia–related hospital admissions identified through databases: economic burden and causes

Cited by 6 publications

References 22 publications

Medication adherence and persistence among patients with non-small cell lung cancer receiving tyrosine kinase inhibitors and estimation of the economic burden associated with the unused medicines

Medication adherence and persistence among patients with non-small cell lung cancer receiving tyrosine kinase inhibitors and estimation of the economic burden associated with the unused medicines

Risk factors for hypoglycaemia in people with diabetes admitted to the Emergency Department of a Hospital in French Guiana

Diabetes Mellitus: Classification and Diagnosis

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