‘Pay for performance’ GP reward scheme sees diabetes drugs unnecessarily prescribed to the elderly

Experts are warning that the elderly are regularly being prescribed unnecessary diabetes medication, due to a reward scheme which incentivises GPs for prescribing drugs.

Diabetes specialists have said the overtreatment, which dates as far back as 15 years, means that frail people are being put at increased risk of falls, dementia and cognitive impairment.

The authors of the report called for all diabetes patients over the age of 70 to be reviewed to ensure that any unnecessary treatment is stopped.

The unnecessary use of the drugs means a risk of pushing blood sugar too low, which puts patients at risk of a dangerous ‘hypo’, which can lead to a serious fall, cognitive impairment or dementia.

The authors of the report wrote “This ‘payment by results’ approach led to an overall improvement in the blood pressure and glycaemic and lipid control in people with diabetes across the UK.

“But the contract did not differentiate based on age, limited life expectancy or frailty.

“Until recently, there were no rules for stopping long-term therapy. As a result, a significant proportion of older adults were commenced on agents more than ten years ago to improve glycaemic control and, despite significant changes in patients’ overall wellbeing and physical status, these medicines have not been reviewed.”

Chair of the Royal College of GPs Professor Helen Stokes-Lampard, said “The Quality Outcomes Framework was designed to maintain and improve the service GPs and our teams deliver for patients.

“As such, it is important that the system is consistently reviewed to ensure it is doing just that – and that emerging ways of thinking, and new, high-quality research is taken on board as part of that process.”

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Posted by Karen Motley, Clinical Negligence Department, Chadwick Lawrence LLP (tonymay@chadlaw.co.uk ), medical negligence lawyers and clinical negligence solicitors in Huddersfield, Leeds, Wakefield and Halifax, West Yorkshire.

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