Overtreatment Common Among Older Diabetes Patients
Overtreatment of diabetes is more common than undertreatment among Medicare recipients, according to the findings of a recent study.
In their study, the researchers analyzed claims data from 78,792 Medicare recipients with diabetes from 10 states. They assessed outpatient laboratory values to determine which patients were being overtreated, which was defined as hemoglobin A1c under 6.5% with prescriptions for any non-metformin diabetes medications. In addition, the researchers examined patient characteristics associated with overtreatment, undertreatment, and deintensification of treatment.
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The researchers found that 8560 (10.9%) Medicare recipients with diabetes were potentially overtreated. Patients who were over 75 years of age and enrolled in Medicaid were more likely to be overtreated, while Hispanic patients were less likely to be overtreated.
Only 14% of overtreated patients had their therapy deintensified. Deintensitification was more common among patients with 6 or more chronic conditions, those with more outpatient visits, and those living in urban areas, but less common among patients over 75 years of age.
Overall, only 6.9% of patients were potentially undertreated. The factors associated with undertreatment were different from those associated with overtreatment.
“Our study points the way for identifying not only those patients who may benefit from more intensive treatment, but also those who may need deintensification,” the researchers concluded. “By focusing at both the overtreatment and undertreatment ends of the diabetes quality spectrum, we can best begin to truly improve the quality of diabetes care, ensuring that patients get needed care while avoiding unnecessary potential harm.”
—Melissa Weiss
Reference:
Maciejewski ML, Mi X, Sussman J, et al. Overtreatment and deintensification of diabetic therapy among Medicare beneficiaries [published online September 13, 2017]. J Gen Intern Med. https://doi.org/10.1007/s11606-017-4167-y.