Quality measures outline three risk factors for hypoglycemia among older adults
Click Here to Manage Email Alerts
The Endocrine Society and Avalere Health introduced quality measures to help health care providers assess how well they identify and care for older adults at greater risk for hypoglycemia.
The Endocrine Society established a technical expert panel in March to develop three outpatient hypoglycemia measures for adults aged at least 65 years with type 2 diabetes, using a literature review to identify relevant guidelines and statements. The age criterion for the measures is limited to older adults due to their increased risk for multiple comorbidities, frailty and other conditions that increase hypoglycemic risk.
The HHS identified hypoglycemia as one of the top three preventable and measurable adverse drug events.
“Hypoglycemia is an area where we can make meaningful strides in improving diabetes care,” James L. Rosenzweig, MD, of Hebrew SeniorLife Rehabilitation Hospital in Boston, who led the expert panel, said in a press release. “Our research has shown a lack of widespread initiatives to address this issue. These first-of-their-kind quality measures will help clinicians better identify patients who are at risk and combat hypoglycemia.”
The quality measures outline key risk factors that raise an individual’s chances of developing hypoglycemia and emphasize the importance of people who meet these criteria receiving education to help prevent future episodes.
Key risk factors include the following:
- experiencing a hypoglycemic event where blood glucose levels dropped below 54 mg/dL and required immediate attention within the past year;
- experiencing altered mental or physical status requiring assistance during a severe hypoglycemic event in the past year; and
- a documented HbA1c of less than 7% in the past 6 months or at least one other relevant chronic medical problem when prescribed insulin or sulfonylurea therapy, which increases risk for hypoglycemia.
The panel also recommends health care providers capture information about hypoglycemic episodes in which individuals experienced altered mental or physical status requiring assistance within the past year. This information can help clinicians better determine whether an individual is experiencing growing unawareness of hypoglycemia over time and identify what kinds of interventions stand the best chance of helping the patient avoid future episodes.
“Avalere is excited to have been involved in the development of measures focused on older adults who are at risk of having hypoglycemia,” Kristi Mitchell, practice director at Avalere Health, said in the release. “To date, there has been a gap in outpatient measures that screens patients for risk of hypoglycemia and setting tailored targets for this population. We look forward to continuing our work with the Hypoglycemia Prevention Initiative to address this need.”
The work on measures was part of a broader quality improvement effort, the Hypoglycemia Prevention Initiative, which was launched by the Endocrine Society and Avalere Health to study how hypoglycemia could be prevented in older adults with type 2 diabetes and whether primary care physicians could incorporate diagnostic and preventive services into their workflow. The researchers noted that the measure set “serves as a starting point” for identifying older adults with type 2 diabetes who are at greater risk for hypoglycemia.
“It is anticipated that these measures will be reassessed and refined as they are tested in the outpatient setting,” the researchers wrote. “Additional measure concepts may be developed based on new evidence or on feedback that is received from stakeholders, including implementers of these measures.” – by Regina Schaffer
Disclosures: The Hypoglycemia Prevention Initiative is supported by Abbott Diabetes Care, Eli Lilly, Merck, Novo Nordisk and Sanofi. Mitchell is practice director at Avalere Health.
Read more about
Click Here to Manage Email Alerts