New Brief by Fred Lu
A study published in the Journal of the American Medical Association Internal Medicine found that many doctors do not alter their treatment of high blood sugar and blood pressure, even after treatment goals are accomplished. After obtaining patient records of over 211,000 patients aged 70 or older with diabetes who received treatment between the years 2012 and 2015 from the U.S Veterans Health Association, researchers found that only 27% of patients being treated for high blood sugar and 19% of patients with high blood pressure had their medications reduced.
This issue stems in part from the fact that practice guidelines recommend getting blood sugar and blood pressure to safe levels by intensifying treatment. However, in the words of lead author Dr. Jeremy Sussman, “As people get older, the risks of overtreating become greater, and the benefits become shorter. We have to start emphasizing that more isn't always better…overtreatment is work, and people are being asked to work hard for something that's counterproductive”. Additionally, Sussman noted that low blood pressure and blood sugar levels could increase the risk of falls, confusion, and adverse drug interactions in patients.
A second study surveyed roughly 600 physicians working for the US Department of Veterans Affairs found that only 1/3 of doctors felt that exceeding treatment guideline targets would benefit patients – the rest of the physicians cited fears about malpractice suits from reducing treatment, impacts on their performance scores, and patient displeasure as reasons for not reducing medication.
Sussman stated that patients should know that “just because a medication was right for you at one point doesn't mean it always will be. At least once a year, talk to your doctor and make sure all of your medications still make sense", highlighting the importance of clear patient communication.
Gordon, Serena. 'Too Many Seniors With Diabetes Are Overtreated'. WebMD. N.p., 2015. Web. 7 Nov. 2015.
Sussman, Jeremy B. et al. 'Rates Of Deintensification Of Blood Pressure And Glycemic Medication Treatment Based On Levels Of Control And Life Expectancy In Older Patients With Diabetes Mellitus'. JAMA Internal Medicine (2015): 1. Web.