The Prevalence and Persistence of Sliding Scale Insulin Use Among Newly Admitted Elderly Nursing Home Residents With Diabetes Mellitus
The Prevalence and Persistence of Sliding Scale Insulin Use Among Newly Admitted Elderly Nursing Home Residents With Diabetes Mellitus
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DOI：
10.1016/j.jamda.2008.06.003
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发表时间：
2008-11-01
影响因子：
7.6
通讯作者：
Sambamoorthi, Usha
中科院分区：
文献类型：
--
作者：
Pandya, Naushira;Thompson, Stephen;Sambamoorthi, Usha
目的：评估老年护理之家（NH）居民滑动标度胰岛素（SSI）治疗的开始和持续性。设计和参与者：NH居民的纵向研究（N = 9804）年龄在65岁及以上的糖尿病患者，他们在2002年至2003年期间入院，并在与营利性养老院连锁相关的长期护理机构居住1个月或更长时间。在入住疗养院期间开始使用胰岛素的患者中，SSI使用率较高（54%），胰岛素订单总数的22%用于SSI。在开始胰岛素治疗后，83%开始接受SSI治疗的居民在研究结束时仍在使用SSI。那些谁没有开始对SSI，33%后来切换到SSI.Discussion：这项研究表明，SSI方案是非常普遍的，一旦启动，往往会继续在治疗老年糖尿病患者新入院的疗养院。多种因素被发现与SSI的开始和持续性显著相关。结论：SSI的高患病率和持续使用与美国医学主任协会指南以及当前的建议不一致。需要进行更多的研究来评估长期护理机构中长期使用SSI的相关结果。（《美国医学发展杂志》，2008年;9：663-669）
Objective: To evaluate the initiation and persistence of sliding scale insulin (SSI) therapy in elderly nursing home (NH) residents.Design and Participants: A longitudinal study of NH residents (N = 9804) with diabetes aged 65 years and older who were admitted between 2002 and 2003 and resided for 1 month or longer in long-term care facilities associated with a for-profit nursing home chain.Results: Rates of SSI use were high among patients who were started on insulin during their stay in nursing homes (54%), and 22% of the total number of orders for insulin were for SSI. After insulin initiation, 83% of residents who were started on SSI remained on it by the end of the study. Of those who had not started on SSI, 33% were later switched to SSI.Discussion: This study demonstrated that SSI regimens were highly prevalent and, once initiated, tended to be continued in the treatment of elderly patients with diabetes newly admitted to nursing homes. Multiple factors were found to be significantly associated with initiation and persistence of SSIConclusion: The high prevalence and persistent use of SSI is inconsistent with the American Medical Directors Association guideline as well as current recommendations. Additional studies are needed to evaluate outcomes associated with prolonged SSI use in long-term care facilities. (J Am Med Dir Assoc 2008;9:663-669)