Medicare Recipients Overtreated for Diabetes

HealthDay News — Medicare recipients are more frequently overtreated than undertreated for diabetes, and those who are overtreated rarely have their regimens deintensified, according to a study published online in the Journal of General Internal Medicine.

Matthew L. Maciejewski, PhD, from the Durham Veterans Affairs Medical Center in North Carolina, and colleagues examined rates of overtreatment and deintensification of therapy for older adults with diabetes, as well as characteristics associated with each. The authors used Medicare claims data from 10 states, linked to outpatient laboratory values. Overtreatment was defined as having glycated hemoglobin <6.5% with fills for any diabetes medications beyond metformin.

The researchers found that 10.9% of 78,792 Medicare recipients with diabetes were potentially overtreated. Those over 75 years of age and enrolled in Medicaid were more commonly overtreated (P <.001), while overtreatment was less common among Hispanics (P =.009). Deintensification of therapy occurred for 14% of overtreated patients. For patients with 6 or more chronic conditions, more outpatient visits, or those living in urban areas, appropriate therapy deintensification was more common, whereas deintensification was less common for those over 75 years. Potential undertreatment occurred in only 6.9% of Medicare recipients.

“Medicare recipients who are overtreated for diabetes rarely have their regimens deintensified,” the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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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. doi:10.1007/s11606-017-4167-y