Deprescribing Diabetes Medications Reduces Risk of Hypoglycemia, Mortality

Deprescribing medication is the planned and supervised process of dose reduction of therapy that is no longer beneficial or may cause harm. However, there is limited evidence of deprescribing practices for chronic conditions, such as diabetes in older patients in the community setting.

Researchers found that deprescribing certain diabetes medications in older patients with well-controlled type 2 diabetes resulted in sustained benefit of reduced risk of hypoglycemia and mortality after one year. The results of the study were presented at the AMCP Annual Meeting during a poster session titled “One-Year Outcomes of a Pharmacist-Managed Antidiabetic Deprescribing Program in an Integrated Healthcare System.”

This retrospective, propensity score-matched cohort study included 685 patients who were enrolled in a deprescribing program between July 1, 2016, and June 30, 2017. Another cohort included 2,055 patients who received usual care; these patients were matched 3:1 to the deprescribing group based on baseline demographics (age, sex, weight, comorbid burden) and clinical variables. Researchers followed patients for one year or until the end of membership or death.

Compared with the usual care group, the deprescribing cohort had a significant lower incidence rate of hypoglycemia (1.6% vs 3.5%; P=0.01), lower mortality rate (6.0% vs 10.8%; P<0.01), and greater change in hemoglobin A1c (HbA1c; 0.3 ± 0.6 vs 0.2 ± 0.7; P<0.01).

There were no between-group differences in the incidence rate of hyperglycemia and proportion of patients at goal HbA1c.

The study was sponsored by Kaiser Permanente.

Hui R, Chang C, Niu FHarano D, Deguzman L, Kao D, Awsare S, Draves M. One-Year Outcomes of a Pharmacist-Managed Antidiabetic Deprescribing Program in an Integrated Healthcare System. Abstract E4. Presented at the AMCP Managed Care & Specialty Pharmacy Annual Meeting, March 25-28; San Diego, CA.