The Drug-PIN® support in the elderly diabetics with high polypathology scores by the MCPS: A preliminary approach to reduce the risk of polypharmacy

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Authors: Antonio Martocchia, Francesco Maria Perulli, Giulia Restuccia, Marina Borra, Maurizio Simmaco, Robert Preissner, Evaristo Ettorre, Paolo Martelletti, and Giorgio Sesti
Page Range: 71-77
Published in: International Journal on Disability and Human Development, Volume 23 Issue 1
ISSN: 2191-1231

Table of Contents

ABSTRACT

Cardiovascular (CV) diseases are still a major cause of morbidity and mortality, particularly in elderly patients with type 2 diabetes (T2D). Objective: The aim of the study was to reduce the CV risk (optimizing the lipid-lowering treatment, LLT) in the T2D patients with polypharmacy/ polypathology (by the Marigliano-Cacciafesta Polypathol-ogy Scale, MCPS) and at the same time, to reduce the risk of the drug-drug interactions (DDIs). Study group: We evaluated 62 elderly patients (>65 years, 23 with T2D and 39 without T2D). Methods: Each patient underwent an evaluation of the clinical/drug history (including the MCPS) and of the cardio-metabolic panel (with a carotid measurement of the intima-media thickness). The CV risk classes were examined according to the current guidelines and the DDIs were examined by the means of the INTERCheck® software and the Drug-PIN® tool. Results: In the elderly patients with and without T2D, the MCPS scores were 45.5+16.0 and 32.5+14.6 (p < 0.01), the ten-year CV risk scores were 29.4+20.3% and 19.6 + 9.9% (p < 0.025), the total INTERCheck® scores were 4.9 + 3.5 and 3.1 + 3.0 (p < 0.05) and the Drug-PIN® scores were 39.7 + 28.4 and 22.9 + 20.3 (p < 0.01), respectively. The INTERCheck® and Drug-PIN® scores were statistically related (p < 0.000001). The Drug-PIN® was useful to guide the LLT, optimizing the LDL goals and reducing the DDIs at the same time (p < 0.0000001). Conclusions: To our best knowledge this is the first report demonstrating that the Drug-PIN® is an useful tool to guide the LTT to achieve the optimal goals in the elderly T2D patients with polypharmacy and to reduce the DDIs. Keywords: Comorbidity, polypharmacy, drug-PIN, INTERCheck, MCPS, Italy

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