Evidence map›Paper›PMID 27052559›Full record

ArticleJournal of the American Medical Directors Association2016

National Trends in Treatment Initiation for Nursing Home Residents With Diabetes Mellitus, 2008 to 2010.

Andrew R Zullo, David D Dore, Lori Daiello, Rosa R Baier, Roee Gutman, David R Gifford, Robert J Smith

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Medical Directors Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 15 citations in OpenAlex.

  1. Trial
  2. Observational
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  6. Comparative safety of sulfonylureas among U.S. nursing home residents.Journal of the American Geriatrics Society · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Andrew R ZulloDepartment of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI. Electronic address: andrew_zullo@brown.edu.
David D DoreOptum Epidemiology, Waltham, MA.
Lori DaielloDepartment of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI.
Rosa R BaierDepartment of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI; Center for Long-Term Care Quality and Innovation, School of Public Health, Brown University, Providence, RI.
Roee GutmanDepartment of Biostatistics, School of Public Health, Brown University, Providence, RI.
David R GiffordQuality and Regulatory Affairs, American Health Care Association, Washington, DC.
Robert J SmithDepartment of Health Services, Policy, and Practice, School of Public Health, Brown University, Providence, RI; Department of Medicine, Alpert Medical School, Brown University, Providence, RI.
Brown University · USAmerican Health Care Association · USOptum (United States) · US

Funding

Develop Patient Centered Outcomes Scholars for Comparative Effectiveness ResearchK12HS022998 · AHRQ · BROWN UNIVERSITY · PI TRIKALINOS, THOMAS · 2014 to 2018
$3.4M
AHRQ HHS K12 HS022998
6 · The paper itself

Abstract

objectiveDiabetes mellitus is common in the nursing home (NH) population, yet little is known about prescribing of glucose-lowering medications in the NH setting. We describe trends in initiation of glucose-lowering medications in a national cohort of NH residents. DESIGN AND

settingRetrospective cohort study using Part A and D claims for a random 20% of Medicare enrollees linked to NH Minimum Data Set (MDS) and Online Survey, Certification, and Reporting (OSCAR) databases in 7158 US NHs.

participantsA total of 11,531 long-stay (continuous residence of ≥90 days) NH residents 65 years or older with diabetes who received a glucose-lowering medication between 2008 and 2010 after 4 months of nonuse. MEASUREMENTS: Medicare Part D drug dispensing of glucose-lowering treatments; resident and facility characteristics preceding medication initiation.

resultsWe observed decreasing sulfonylurea initiation from 25.4% of initiations in 2008 to 11.7% in 2010, an average decrease of 1% per quarter (95% CLs -1.5 to -0.5). Thiazolidinedione initiation decreased from 4.7% to 1.9%, an average decrease of 0.3% per quarter (95% CLs -0.4 to -0.2), and meglitinide initiation from 1.5% to 0.3%. No appreciable linear trends were observed for metformin (range 12.0%-18.8%) and dipeptidyl peptidase-4 (DPP-4) inhibitors (range 0.9%-2.7%). In contrast, insulin use increased from 51.7% to 68.3% during the same time period, driven by a marked increase in initiation of rapid-acting insulin (11.0% to 29.4%; average increase of 1.4% per quarter, 95% CLs 0.9-1.9) and a modest increase in short-acting insulin (22.6% to 30.3%; an average increase of 0.6% per quarter, 95% CLs -0.1 to 1.3).

conclusionsBetween 2008 and 2010, there were substantial decreases in the use of oral glucose-lowering agents and corresponding increases in the use of insulin among long-term residents of US NHs.

Indexed as

Nursing HomesAgedAged, 80 and overDiabetes MellitusFemaleHumansInsurance Claim ReportingMaleMedicare Part DQuality of Health CareRetrospective StudiesTime FactorsUnited Statesdiabeteslong-term careNursing homepharmacotherapyquality of caretreatment choice variation

Identifiers

PMID27052559
PMCPMC4925288
OpenAlexW2304985007

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.