Almost 60% of diabetic nursing home residents with chronic kidney disease are on a potentially problematic drug regimen, study finds

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Nursing home residents who have diabetes and chronic kidney disease are commonly given medications that are not in keeping with best practice guidelines or prescribing information, according to recently published research.

Investigators analyzed AnalyticCare LTC's database, looking at information of about 10,000 nursing home residents from the 2008 to 2011 time period. Out of more than 3,220 diabetic residents, nearly half had moderate or severe chronic kidney disease, the researchers found.

The researchers determined which of these residents were taking an oral antidiabetic drug (OAD) that had been included medication best practices guidelines created by the National Kidney Foundation. About 28% were receiving an OAD that was not in accordance with those guidelines, the research team discovered.

Furthermore, about 57% did not receive OADs in accordance with prescribing information, according to the investigators. Metformin was the drug most commonly being misused.

“Physicians should consider residents' renal function when choosing treatment plans and review treatments regularly to check compliance with the NKF guidelines or PIs,” the study authors wrote.

The authors were affiliated with the University of Utah School of Pharmacy, Boehringer Ingelheim Pharmaceuticals and the Health Economics and Epidemiology wing of research and consulting group Evidera. The authors declared no conflicts of interest.

Findings appear in the International Journal of Nephrology.

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