(078) Two-arm Study on Deprescribing of Antihyperglycemic Agents Causing Hypoglycaemia Among Geriatric Patients

Background: Deprescribing is a systematic process of withdrawal, dose reduction, frequency reduction, switching to appropriate medications and cessation of potentially inappropriate medications (PIMs) to reduce polypharmacy and maintains the Quality of Life (QoL).

Objectives: The study aimed to deprescribe antihyperglycemic agents causing hypoglycaemia among geriatric patients and identify the Qol (QoL) of patients.

Methods: It is a two-arm prospective interventional study carried out for six months from January 2023 to June 2023. The study was conducted in the Department of Endocrinology of a tertiary care hospital. Patients suffering from Type 2 Diabetes and are above 65 years of age, patients having HbA1c level less than 9% and patients suffering from adverse reaction of hypoglycaemia caused by insulin and sulphonylurea were included. Patients suffering from organ failure, patients having co-morbid conditions like chronic kidney disease and decompensated chronic liver disease were excluded from the study. Mann-Whitney U Test was performed to analyze the data. Ethical approval was obtained from the Ethics Committee of Ramaiah University of Applied Sciences, Bangalore.

Results: The study included a total of 90 participants among which 59 (66%) were males and (31) 34% were females. It was identified that among the patients involved in the study, 37 (41.11 %) had HbA1c level between 7– 7.9 %, 35 (38.89 %) had HbA1c level between 8-8.9 %, and 18 (20 %) had HbA1c level between 6-6.9 %. The mean age of the patients was identified to be 68.68 years with standard deviation 2.9. Mean weight was 71.25 kgs with a standard deviation 11.19. Mean height was 164.26 centimetres with a standard deviation of 9.62 and the mean body mass index was 26.50 with standard deviation 3.99. Mean HbA1c level was 7.55 with a standard deviation of 0.72. Among a total of 90 patients involved in the study, 15 patients (33.3%) achieved deprescription like dose, frequency, drug reduction, drug change to safer alternatives and completely stopped oral hypoglycaemics etc. The results of the Mann-Whitney U test revealed that there were significant differences in the results of responses between the variables of Pre- and Post-deprescribed patients. The p-value is <.00001, indicating the significant value at p<.05.

Conclusions: Deprescription in type 2 diabetes mellitus patients led to improved treatment satisfaction and enhanced Qol. Patients with higher education levels showed greater satisfaction levels. Overall, deprescription appears to be a valuable therapeutic approach to reduce medication burden, improve patient well-being, and achieve efficient glycemic control. Further research and continuous medical education programs are recommended to optimize diabetes management in different patient groups.