The application of the STOPP/START criteria in the elderly patients with type 2 diabetes mellitus and essential hypertension at the endocrinology department of a multidisciplinary hospital

Objective. To assess the polypharmacy and the appropriateness of prescribed drugs according to the STOPP/START criteria of elderly patients with type 2 diabetes mellitus (T2DM) а nd essential arterial hypertension (HTN) at the endocrinology department of a multidisciplinary hospital. Design and methods . Medical records of 260 patients ≥ 65 years old (65-93 years old, average age — 75,2 ± 6,8 years, 219 women) with T2DM and HTN admitted to the endocrinology department of the multidisciplinary hospital (Moscow, Russia) were analyzed according to the “STOPP/START” criteria. Results. Five and more medications (polypharmacy) were simultaneously prescribed in 211 people (81,2 %). We identified that potentially not recommended (which should be avoided in certain cases) drugs were prescribed to 58 patients (22,3 %). At the same time 178 patients (65,4 %) did not get prescription for the recommended medications. The most frequent identified STOPP criteria included: 1) glibenclamide or chlorpropamide or glimepiride in patients with T2DM (29,5 %); 2) loop diuretics in the absence of clinical signs of heart failure (17,9 %); 3) glibenclamide in T2DM (15,4 %). The most frequent START criteria included: 1) statin therapy in patients with the documented history of coronary, cerebral or peripheral vascular disease, where the patient’s functional status remains independent for daily activities and life expectancy is more than 5 years (30,5 %); 2) aspirin with the documented history of atherosclerotic coronary disease in patients with sinus rhythm (16,3 %); 3) clopidogrel with a documented history of cerebral or peripheral vascular disease (15,1 %). Conclusions . According to our data, in patients aged 65 years and older with T2DM and HTN, polypharmacy occurs in more than 80 % of cases. In patients ≥ 65 years old with T2DM potentially not recommended drugs are often administrated, while recommended medications are not prescribed. Our findings demonstrate the need for optimization of pharmacotherapy in elderly and senile patients with T2DM and HTN.